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The article provides a historical overview of the Journal of Dermatologic Surgery, tracing its origins back to the founding of the American Society for Dermatologic Surgery in 1970. The journal has evolved over the years under the leadership of various editors, each contributing to its growth and development. Notable milestones include the transition to electronic submissions, the expansion of editorial leadership, and the introduction of podcasts to enhance accessibility to the journal's content. As the journal approaches its 50th anniversary, it continues to be a significant resource for dermatologists worldwide, showcasing top-quality peer-reviewed content that has shaped the field of dermatologic surgery. [Extracted from the article]

The article discusses a successful allogeneic hair transplantation procedure performed on a 37-year-old woman with extensive cicatricial alopecia resulting from discoid lupus erythematosus. The patient's identical twin sister served as the donor for the procedure, which took place in August 2022. Follow-up examinations showed significant improvement in hair density and no reactivation of the underlying inflammatory scalp disease. The case introduces the potential option of allogeneic hair transplantation for patients with scarring alopecia, highlighting a unique approach to hair restoration in such conditions. [Extracted from the article]

The article discusses the use of cross-polarized loupes during Mohs Micrographic Surgery to eliminate surface reflectance and reduce eye strain for surgeons. By polarizing both the light source and loupe lenses, glare from metallic instruments or wet surfaces can be minimized, leading to improved visualization of tissue structures. The technique enhances margin evaluation for skin tumors, improves biopsy site identification, and provides a more comfortable and precise surgical experience. The authors recommend dermatologic surgeons consider adopting this method to enhance surgical outcomes and protect their long-term eye health. [Extracted from the article]

Purpose: To describe a case of endogenous endophthalmitis as a complication from hair transplantation. Methods: Case report of a 53-year-old man with a history of recent hair transplantation. Results: The patient presented with a febrile illness and blurry vision 1 week after hair transplantation. Infectious workup included blood cultures positive for methicillin-resistant Staphylococcus aureus, and he was treated with IV antibiotics. Initial ocular examination demonstrated 20/30 and hand motions in the right and left eyes, respectively, with significant vitritis. He underwent vitreous tap and injections of vancomycin and dexamethasone in both eyes and removal of purulent staple from the site of recently transplanted hair. His ocular and systemic symptoms improved. Approximately 3 months after initial clearing of the initial infection he had recurrence of bacteremia that prompted repeat intravitreal and systemic antibiotics. His vision returned to baseline with mild residual optic nerve pallor and atrophic retinal changes in the left eye. Conclusion: Hair transplantation is associated with minimal systemic complications, but in rare cases, sepsis is possible and can result in intraocular seeding causing endophthalmitis. MRSA endogenous endophthalmitis frequently results in negative vitreous taps and treatment outcomes in the literature have been shown to vary widely including a return to baseline vision as in the described case. [ABSTRACT FROM AUTHOR]

This article discusses a cross-sectional study of Reddit discussion posts on the topic of skin bleaching and the barriers to health literacy associated with it. The authors present ultrasound findings as a noninvasive alternative to biopsy for diagnosing certain skin conditions. They also introduce a new therapeutic option, minimally invasive hair transplantation, for the treatment of nevus psiloliparus. The article emphasizes the importance of recognizing and addressing the infrequent condition of nevus psiloliparus in clinical settings. [Extracted from the article]

The document discusses a study on the effectiveness of microneedling (MN) as a treatment for androgenetic alopecia (AGA), a type of hair loss. The study compared three different needle depths and found that a 0.5-mm depth of MN showed the greatest effectiveness in enhancing hair regrowth compared to 1-mm or 1.5-mm depths. The study suggests that MN alone may be a viable treatment option for AGA, but further research is needed to determine the optimal depth and frequency of MN sessions. The document also briefly mentions the use of MN in other hair loss disorders and highlights the need for more research in this area. Additionally, the document briefly mentions the topic of skin bleaching and the importance of understanding the language used by patients in online discussions about this practice. [Extracted from the article]

The article discusses a rare case of diaphragmatic spasms caused by a glomangioma. The patient developed scalp swelling seven months after a hair transplant, which was attributed to an infection from the hair transplantation procedure. The article recommends that patients with allogenic cranioplasty flaps, like the one in this case, should be warned about the possibility of infection spreading to the underlying implant before undergoing hair transplantation. The article also mentions the use of prophylactic antibiotics and staphylococcal decolonization regimen as preventive measures. Additionally, the article briefly mentions other studies on glomangiomas in different parts of the body. Another article in the same journal discusses a novel and simple method called no-laboratory epidermal cell paste (NLEP) for the treatment of stable vitiligo. The NLEP technique does not require specialized laboratory equipment, is less time-consuming, and more cost-effective compared to other cellular graft methods. The article provides details of three patients who underwent the NLEP procedure and achieved repigmentation with minimal adverse effects. [Extracted from the article]

This document discusses a case study of a 14-year-old patient who presented with painful bluish lesions on his back that caused diaphragmatic spasms. The patient had previously been diagnosed with glomangioma, a condition characterized by the proliferation of glomus cells with a vascular component. The spasms were debilitating and had a significant impact on the patient's daily life. The authors highlight the unique presentation of glomangioma in this case and emphasize the need for further research and understanding of this condition. [Extracted from the article]

The article discusses the challenges and potential correlations in regrowing hair with lasers in androgenetic alopecia. It mentions that somatic mutations may affect the development of post-inflammatory hyperpigmentation (PG) and that further research is needed to determine the relationship between PDT, somatic mutations, and PG formation. The article also explores the vascular anomalies in port-wine stains (PWS) and suggests that the vascular pattern of PWS may need to be reconceptualized. Overall, the cases presented in the article provide valuable references for future research on PDT protocols and the pathogenesis of PG. Additionally, the article briefly mentions a multicenter study on beard and body hair transplantation using a skin-responsive device, highlighting the challenges and outcomes of nonscalp FUE procedures. [Extracted from the article]

BACKGROUND The hair-bearing scalp is an underused donor site for split-thickness skin grafts (STSG). OBJECTIVE Evaluating the donor site scar outcomes, healing times, and complications associated with STSG harvested from the hair-bearing scalp. MATERIALS AND METHODS During this prospective observational study, donor site healing was assessed on postoperative Days 8 and 30. Donor site scar outcomes were quantified at 1 month using the Vancouver Scar Scale. All postoperative complications were collected during the 30-day follow-up window. RESULTS 80% of donor sites was fully healed at 1-week follow-up. Vancouver Scar Scale score at the donor site was 0.26 at 1-month follow-up. All patients experienced full hair regrowth. Maximum pain scores were reported on the night of surgery (Vancouver Scar Scale 1.8), with quick resolution in days to follow. No major complications were reported. All STSG obtained from the scalp had full take and good texture and color match with the recipient site. CONCLUSION The hair-bearing scalp is an excellent donor site for split-thickness skin graft harvesting. [ABSTRACT FROM AUTHOR]

This article discusses the reconstruction of a large scalp defect in a 73-year-old male patient with acantholytic squamous cell carcinoma. The article explores the challenges of reconstructing large scalp defects and the various techniques that can be used, such as skin grafts, flaps, and tissue expansion. The authors describe their chosen technique, the temporoparietal fascial sling island pedicle flap, which allows for full defect coverage, preservation of tissue, and minimal tension. The article provides a detailed surgical technique for this method and highlights its advantages over other techniques. [Extracted from the article]

The article in Dermatologic Surgery introduces a new technique using rubber bands to improve the surgical field for patients with multiple trichilemmal cysts on the scalp. This method allows for the removal of multiple lesions simultaneously without the need to shave large areas, reducing surgery time and minimizing cosmetic impact. The authors highlight the effectiveness, affordability, and simplicity of this approach compared to other methods like disposable combs, making it a valuable alternative for dermatologists treating scalp lesions. [Extracted from the article]

This document discusses a study on large volume breast tumescent autologous fat transfer. The study found that there was no significant difference in torque or movement duration between beard and body follicular unit extraction (FUE). Body FUE required higher RPM and had a higher transection rate (TR) compared to beard FUE. Most patients had Class I scalp donors, and Class I donors required lower RPM and shorter movement duration. At the 6-month follow-up, the majority of patients rated their outcome as "very happy." The study suggests that the single-follicle rotational device (SFRD) used in the procedure contributed to the reduced TR and improved surgeon receptivity. The study has limitations, including its retrospective nature and small sample size. [Extracted from the article]

The article discusses the use of follicular unit excision (FUE) for beard and body hair transplantation. It mentions that patients with darker skin phototypes may have limited benefits from FUE due to the use of lower energy parameters to avoid hyperpigmentation. The article also highlights the need for further research to determine optimal treatment parameters. Additionally, the article briefly mentions a separate topic on large volume breast tumescent autologous fat transfer. [Extracted from the article]

This article discusses the repair of a lateral eyebrow defect in a 64-year-old woman who had a basal cell carcinoma. The goal of the reconstruction was to maintain a symmetrical shape and hair pattern relative to the contralateral brow. The authors describe a technique called a banner transposition flap, which used a superolateral tissue reservoir to restore the eyebrow. The patient had a successful outcome with minimal complications and was pleased with the results. The article emphasizes the importance of eyebrows for aesthetics, emotion, communication, and identity, and provides insights into the challenges and options for reconstructing lateral eyebrow defects. [Extracted from the article]

BACKGROUND Follicular unit excision is a favored minimally invasive hair transplantation method. However, it is suboptimal for many patients of African descent because of wide variations in hair and skin characteristics. OBJECTIVE To evaluate the performance of a skin-responsive follicular unit excision device, which accommodates hair curliness, skin thickness, and firmness in patients of African descent. MATERIALS AND METHODS The authors retrospectively evaluated patients who underwent scalp follicular unit (FU) excision using a skin-responsive technique at 7 multinational clinics. The preoperative donor grading for the anticipated difficulty used a scale with Class V indicating the highest degree of hair curliness, skin thickness, and firmness. RESULTS Of 64 eligible patients (45 males and 19 females), 28 had Class V FU excision donor grades. The mean transection rate for all patients was 3%-6%, which was highest in class V patients. Skin thickness and firmness had a greater effect on the maximum transection rate than hair curliness. Only 19 or 18 G punches were used. CONCLUSION The authors report consistence success of a new skin-responsive FU excision device for all patients of African descent with a mean graft transection rate of less than 10%. The findings support skin thickness and firmness as major influencers of graft attrition rate. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. BACKGROUND: Hair transplantation has become a popular choice for alopecia treatment; however, postsurgical hair shedding still annoys both patients and surgeons. OBJECTIVE: To explore the impact of graft-holding solution on postsurgical hair shedding and testify the protective efficacy of histidine-tryptophan-ketoglutarate solution with adenosine triphosphate and deferoxamine (HTK-AD). METHODS: There were 240 patients enrolled in the study, and the follicles were placed into either HTK-AD or Ringer solution (RS). Masson staining and live/dead staining were performed to evaluate graft morphology and apoptosis levels, respectively. The between-group comparison of postsurgical graft shedding, survival rate, complications, and patient satisfaction was performed. RESULTS: Grafts in HTK-AD maintained organized dense collagen construction and higher cell viability, but those preserved in RS became soft, which hindered implantation. Histidine-tryptophan-ketoglutarate solution with adenosine triphosphate and deferoxamine significantly reduced the incidence of postsurgical hair shedding (73.81% vs 95%), delayed shedding onset, and diminished shedding amount versus RS (p <.05) when ≥3,000 grafts were transplanted. The shedding duration was shortened, and hair regrowth started earlier in HTK-AD versus RS (p <.05); thus, satisfaction was increased. The final survival rate showed no difference between 2 groups. CONCLUSION: Histidine-tryptophan-ketoglutarate solution with adenosine triphosphate and deferoxamine is superior to RS for hair graft preservation because it improves graft viability and alleviates postsurgical shedding. [ABSTRACT FROM AUTHOR]

BACKGROUND The prevalence of work-related musculoskeletal disorders (WRMD) is increasing among all surgical specialties. OBJECTIVE Results of a cross-sectional survey of hair transplant surgeons were analyzed, with the aims to (1) determine the prevalence of WRMD, (2) assess risk factors associated with musculoskeletal (MSK) symptoms, and (3) identify mitigation measures. MATERIALS AND METHODS A survey pertaining to demographics, MSK-related symptoms and its impacts, and pain mitigation measures taken, if any, were distributed to 834 hair transplant surgeons. Risk factors associated with pain severity were assessed using linear regression. RESULTS Overall, 78.5% (73 of 93) respondents had experienced pain when performing surgery. Musculoskeletal symptoms were most severe in the neck, followed by upper/lower back, and extremities. Number of grafts performed per session of follicular unit extraction positively correlated with pain severity; female surgeons and surgeons aged.71 years were at higher risk. A majority expressed concern that WRMD may limit their career and agreed to a need for improved workplace education. Strength training and ergonomic improvements of surgical procedure were not commonly adopted. CONCLUSION In sum, WRMD can be debilitating in health care professionals. Workplace ergonomic adjustments and physical exercise programs may be warranted to better mitigate MSK symptoms. [ABSTRACT FROM AUTHOR]

This article discusses the quality of photographs of tumor biopsy sites referred for Mohs micrographic surgery at an academic medical center. The authors evaluated biopsy photographs from a specific time period and analyzed them based on various criteria, such as the use of tools, presence of anatomic landmarks, and angle of the photograph. They found that while most surgical sites had biopsy photographs, the quality could be improved, especially for sites on the scalp. The authors suggest including anatomic landmarks in photographs to facilitate better identification of scalp lesions. [Extracted from the article]

The document titled "The Founding of the American Society for Dermatologic Surgery" reflects on the history of dermatologic surgery in the United States. It highlights the early pioneers in the field, such as Dr. Charles "Ted" Lincoln, who performed hair transplants and taught techniques like dermabrasions and acid peels. The American Society for Dermatologic Surgery (ASDS) was established in the 1960s by a group of dermatologists interested in surgery, with Dr. Norman Orentreich serving as the first president. The ASDS has since grown and evolved, showcasing the advancements made in dermatologic surgery over the years. [Extracted from the article]

The hair-bearing superficial temporal artery flap is one of the traditional options for total eyebrow reconstruction. The anatomical variation of the superficial temporal artery has been well discussed; however, the anatomy of the superficial temporal vein is highly diverse. The authors report the use of preoperative computed tomography (CT) angiography in a 27-year-old man with a total eyebrow defect caused by thermal burn injury. The authors harvested a 6×1.5-cm pedicled hair-bearing superficial temporal artery flap from the area where the parietal branches of the superficial temporal artery and vein were running in close proximity, according to the CT angiography findings. Postoperatively, the flap survived completely without any vascular compromise. The authors believe that preoperative visualization of the superficial temporal vessels with CT angiography is highly beneficial in performing safe eyebrow reconstruction with a hair-bearing superficial temporal artery flap., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by Mutaz B. Habal, MD.)

Background: Postoperative folliculitis is a common complication of hair transplantation (HT) requiring effective preventive interventions. This study characterized postoperative folliculitis and determined risk factors in patients undergoing HT., Methods: The authors retrospectively reviewed 1317 patients who underwent HT and completed 9-month follow-up between January of 2018 and June of 2021 at 4 medical centers. The incidence of postoperative folliculitis and demographic characteristics were assessed. Logistic regression analysis was used to identify risk factors, and the characteristics of different types of folliculitis were compared., Results: The overall incidence of postoperative folliculitis was 12.11%, and clinical characteristics varied among the different types of folliculitis. Surgery in summer (OR, 1.772 [95% CI, 1.05 to 2.992]), number of transplant grafts 4000 or greater (OR, 4.818 [95% CI, 1.45 to 16.014]), transplant density greater than 45 grafts/cm 2 (OR, 2.152 [95% CI, 1.376 to 3.367]), and first nursing time greater than 3 days (OR, 1.555 [95% CI, 1.088 to 2.223]) were the main risk factors for postoperative folliculitis., Conclusions: Postoperative folliculitis after HT presents different characteristics. Surgical factors and postoperative nursing care were demonstrated to be related to folliculitis. The authors propose a preventive folliculitis model based on preoperative, intraoperative, and postoperative factors., Clinical Question/level of Evidence: Risk, III., (Copyright © 2023 by the American Society of Plastic Surgeons.)

Supplemental Digital Content is Available in the Text. BACKGROUND: The frontal–temporal triangle area (FTTA) hair has a slow growth rate and thin caliber, which are similar to those of eyebrow hair. However, a comparison of cosmetic outcomes between FTTA and other scalp hair grafts in eyebrow transplantation has not been performed. OBJECTIVE: To compare the cosmetic outcomes of FTTA hair and periauricular and occipital area (POA) hair in eyebrow restoration. METHODS: A retrospective analysis of 155 patients with FTTA or POA hair transplants was performed. Comparative variables included patient characteristics, hair density, diameter, percentage of one-hair follicular units (FUs), number of transplanted FUs, harvesting time, transection rate, hair survival rate, frequency of eyebrow trimming, and patient satisfaction. RESULTS: There was a significant difference in hair density, diameter, percentage of one-hair FUs, and harvesting time between the FTTA and POA hair transplants. The FTTA hair grew significantly slower than the POA hair did. The patients in the FTTA group trimmed their postoperative eyebrows at a significantly longer interval than those in the POA group. The percentage of patients who were very satisfied with the surgery results was higher in the FTTA group. CONCLUSION: The FTTA hair grafts can provide aesthetically pleasing cosmetic results in eyebrow restoration. [ABSTRACT FROM AUTHOR]

BACKGROUND: Limited information exists on the long-term risks to individuals undergoing procedures in hair restoration surgery. The short-term risks are well known and similar to other procedures in dermatologic surgery. The long-term risks of hair restoration surgery are seldom discussed between the physician and patient. OBJECTIVE: The author sought to describe a classification system that can be used as a communication tool between physicians and patients to define the long-term risk involved with hair restoration surgery. METHODS: The Progressive Loss (PL) Scale is an attempt at assessing the cosmesis because of future hair loss following a hair transplant procedure. The PL Risk Scale has designated 5 levels, 1 to 5, with each ascending level representing a higher level of risk. The PL Risk Scale can be assigned to an individual at the time of the assessment for hair restoration surgery. RESULTS: Each patient can be assigned a risk level based on how future hair loss may affect the overall cosmetic result of their hair transplant. This risk is dependent on age, and specific for the area to be transplanted. The younger the age of the patient, the higher the risk. The larger the area to be transplanted, the higher the risk. It is not a static scale, because it will be affected by age, donor area, location of transplantation, and other mitigating factors. CONCLUSION: Pattern baldness in men and women is progressive and unrelenting. The dichotomy of hair restoration surgery is that a satisfactory short-term outcome can evolve to disappointing results because of progressive hair loss. The PL Risk Scale can be assigned to every individual undergoing a hair restoration procedure. This scale assignment will convey to the patient their lifetime risk associated with any given surgical hair restoration procedure for that age and the specific area to be restored. [ABSTRACT FROM AUTHOR]

Background: Follicular vitiligo is a distinct subtype of vitiligo characterized by the selective destruction of the follicular melanocytic reservoir. Treatment of follicular vitiligo-associated leukotrichia has always been a clinical challenge., Methods: Twenty participants (mean age, 29 years) with stable follicular vitiligo were recruited between 2020 and 2021 for 2-stage surgery. In stage 1, an incision around the vitiligo lesion was performed to subcutaneously dissect and scrape the leukotrichia. In stage 2, healthy follicles obtained from the occipital donor site were transplanted into the vitiligo area. Follow-up examinations were conducted for 1 year postoperatively using a camera and dermatoscope to observe the growth rate, color, and surviving number of the transplanted hairs. Patient satisfaction was recorded to evaluate the potential surgical improvement., Results: The transplanted hair grew with natural texture, as expected. The average survival rate of the transplanted hair follicles was 93.8%. No recurrence of leukotrichia was observed in the recipient area. No complications were observed, and the postoperative scars in the recipient area were entirely covered by black hair. All patients were satisfied with their resulting appearance., Conclusion: Minimally invasive removal of leukotrichia combined with hair transplantation might be an appropriate surgical option for stable follicular vitiligo to create natural and stable pigmented hair., Clinical Question/level of Evidence: Therapeutic, IV., (Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Plastic Surgeons.)

Supplemental Digital Content is Available in the Text. BACKGROUND: Recent advances in robotic surgery have extended to hair restoration surgery, using a robotic recipient site creation device. OBJECTIVE: This study aimed to assess the surgical safety and postoperative clinical outcomes of using this robotic system. MATERIALS AND METHODS: Thirty-one men diagnosed with androgenetic alopecia, who underwent hair transplantation with robotic recipient site creation, were retrospectively reviewed. Their mean age was 38.7 ± 9.5 (range, 22‒67) years. RESULTS: The total number of robotically created recipient sites was 36,273. The average site creation speed was 1,593 ± 544 sites per hour. Postoperative crusting (54.8%) was the most frequent complication in the recipient area, followed by pruritus (12.9%), asymmetry (6.5%), and folliculitis (6.5%). The mean score of cosmetic outcomes and patient satisfaction, scored on a 5-point scale, was 4.10 ± 0.54 and 4.13 ± 0.85, respectively. No significant differences in cosmetic outcomes and patient satisfaction were found between 3 operators. CONCLUSION: The current device can automatically make slit incisions in the recipient area with speed and consistency noninferior to manual site creation. It is both safe and reliable for clinical use, and it is also easily managed by different hair surgeons without a long learning curve. [ABSTRACT FROM AUTHOR]

BACKGROUND Hair transplantation in scarring alopecia is challenging and transplant surgeons are hesitant due to fear of poor graft survival apart from the risk of reactivating the disease. OBJECTIVE Survival rate of hair follicles transplanted in cases of lichen planopilaris (LPP). To correlate histopathological and ultrasonography findings and their impact on graft survival. METHODS In 32 patients of inactive LPP included, a 5-cm² recipient area was tattooed. The follicular unit density of the transplanted area was 20 to 25 FU/cm2. Postoperative follow-up was conducted at 6, 12, and 24 months. The recipient area density and ultrasound biomicroscopic parameters were assessed at each follow-up visit. RESULTS The survival of grafts was 78.62% at 12 months, and 79.96% at 24 months. Histopathology variables studied at the time of transplantation such as epidermal atrophy, fibrosis, and inflammatory infiltrate were not found to have any effect on the graft survival. Ultrasonography parameters of the involved scalp skin were found to be markedly improved on follow-up. This suggests that the overall health of the scalp improved after hair transplantation. CONCLUSION Follicular unit excision is a ray of hope for cases of primary cicatricial alopecia such as LPP because the result is satisfying to both the patient as well as the doctor. [ABSTRACT FROM AUTHOR]

BACKGROUND Dermatologists specialize in treating conditions of the skin, hair, and nails; however, it is our experience that the field of nail diseases is the least discussed facet of dermatology. Even less acknowledged is the complexity of nail procedures and how best to accurately code for these procedures. OBJECTIVE To convene a panel of experts in nail disease to reach consensus on the most accurate and appropriate Current Procedural Terminology (CPT) codes associated with the most commonly performed nail procedures. METHODS A questionnaire including 9 of the most commonly performed nail procedures and potential CPT codes was sent to experts in the treatment of nail disease, defined as those clinicians running a nail subspecialty clinic and performing nail procedures with regularity. A conference call was convened to discuss survey results. RESULTS Unanimous consensus was reached on the appropriate CPT codes associated with all discussed procedures. LIMITATIONS Although this article details the most commonly performed nail procedures, many were excluded and billing for these procedures continues to be largely subjective. This article is meant to serve as a guide for clinicians but should not be impervious to interpretation in specific clinical situations. CONCLUSION Billing of nail procedures remains a practice gap within our field. The authors hope that the expert consensus on the most appropriate CPT codes associated with commonly performed nail procedures will aid clinicians as they diagnose and treat disorders of the nail unit and encourage accurate and complete billing practices. [ABSTRACT FROM AUTHOR]

BACKGROUND To achieve a natural postoperative appearance, hair grafts are often de-epithelialized from the epidermis during follicular unit extraction (FUE). However, the effect of de-epithelialization on the survival rate of transplanted hair follicles (HFs) has not been investigated. OBJECTIVE To investigate the effect of de-epithelialization on the survival rate of transplanted HFs. METHODS A total of 64 male patients with androgenetic alopecia were included in this study. They were randomly divided into de-epithelialization and control groups. Organ culture was performed to assess the elongation of hair shaft and the percentage of anagen HFs in both groups. Patients were followed up postoperatively to evaluate complications, postoperative shedding, survival rates, and satisfaction. RESULTS No significant difference in hair shaft elongation and percentage of anagen HFs was observed between both groups. The immediate postoperative satisfaction in the control group was much lower than that in the de-epithelialization group (71.25% and 100%, respectively). No significant differences in shedding rate, graft survival rate, and complications were noticed between both groups. CONCLUSION Follicular de-epithelialization does not affect the survival rate of graft in FUE. Based on these data, de-epithelialization may improve immediate postoperative appearance and lead to a more pleasing cosmetic outcome. [ABSTRACT FROM AUTHOR]

BACKGROUND Various types of follicular trauma occur during follicular unit excision (FUE). However, the effects of different types of follicular injury on graft survival have not been reported. OBJECTIVE This study was performed to evaluate the differences in hair follicle survival by the type of follicular injury, including paring, fracture, and bulb injury. METHODS Seven healthy patients who underwent hair transplant surgery by FUE were enrolled in the study. For each patient, 10 single-hair follicular unit grafts per injury group (paring, fracture, bulb injury, or intact) were differentiated. Using sharp implanters, 10 grafts of each of the 4 injury types were transplanted into mice, and the mice were sacrificed 5 months after transplantation. The skin was excised at each of the 4 locations, and newly formed follicular units were counted and photographed under a microscope. RESULTS Of 70 hair follicles in each group, the number of successfully engrafted follicles was 50 (71.43%) in the intact group, 36 (51.43%) in the paring injury group, 9 (12.86%) in the fracture injury group, and 31 (44.29%) in the bulb injury group. CONCLUSION Grafts with minor injury had a lower survival rate than intact grafts. Fractured follicles showed the lowest survival rate. [ABSTRACT FROM AUTHOR]

Background: Postburn scarring alopecia on hair-bearing aesthetic subunits causes cosmetic disfiguring and psychological problems. Follicular unit extraction (FUE) hair transplantation is an effective technique for camouflaging postburn scarring alopecia. However, poorly vascularized and fibrotic scar tissue limits the viability of grafts. The mechanical and vascular characteristics of scar tissue can be improved by nanofat grafting. This study aimed to present the results of postburn scarring alopecia treatment using nanofat-assisted FUE hair transplantation., Methods: Eighteen patients who had postburn scarring alopecia in and around the beard were enrolled. Patients underwent single-session nanofat grafting and FUE hair transplantation at 6-month intervals. Twelve months after hair transplantation, the survival rate of transplanted follicular graft, scar improvement, and patient satisfaction were assessed by counting each transplanted follicle individually, using the Patient and Observer Scar Assessment Scale, and using a 5-point Likert satisfaction scale, respectively., Results: Nanofat grafting and hair transplantation were successfully performed without complication. All scars significantly improved in mature characteristics ( P < 0.00001 for patients; P < 0.00001 for observers). The survival and density rates of transplanted follicular units ranged from 77.4% to 87.9% (mean, 83.2% ± 2.5%) and 10.7% to 19.6% (mean, 15.2% ± 2.46%), respectively. All patients reported significantly satisfying cosmetic results ( P < 0.00001)., Conclusions: Scarring alopecia is an inevitable and challenging late complication of deep burned hair-bearing units. Combining nanofat injection and FUE hair transplantation is among the most innovative and effective treatments for postburn scarring alopecia., Clinical Question/level of Evidence: Therapeutic, IV., (Copyright © 2023 by the American Society of Plastic Surgeons.)

BACKGROUND Follicular unit extraction (FUE) is becoming more popular in hair restoration. However, its potential for treating extensive scarring alopecia is unknown. METHODS Patients with scarring alopecia larger than 100 cm² were enrolled from 2015 to 2018. After assessing scar quality regarding vascularity, pliability, and thickness, dense-packing megasession (DPM)-FUE was performed on high-quality recipient sites. Patients were followed up at 1 week and 12 months postoperatively to evaluate complications, survival rates of grafts, and patient satisfactions. Cases of nonscarring alopecia were reviewed as controls. RESULTS Fifty-two scarring alopecia and 55 nonscarring alopecia patients were enrolled. The mean scar area was 120 cm², and the procedure required an average of 8 operative hours, with no difference between groups (p > .05). Graft amount and postoperative complications were similar as well (p > .05). The survival rate in scarring alopecia was lower than that in the control but was still 85% (p < .05). Follow-up photographs showed effective scar camouflage after DPM-FUE. Most patients were very satisfied with the final results (p > .05). CONCLUSION DPM-FUE is a safe and effective treatment for extensive scarring alopecia. [ABSTRACT FROM AUTHOR]

BACKGROUND Follicular unit excision (FUE) is used to harvest follicular units for hair transplantation using trephine punches. The characteristics of FUE punches can impact the success of this technique; thus, many innovative punch designs and devices have been developed. With many options available, it can be difficult for the hair restoration surgeon to know which punch best suits the needs of their patients. OBJECTIVE To provide a comprehensive review of punch shapes and devices available. METHODS Search of PubMed, reference mining of relevant publications, and hand searching trade publications. RESULTS We examined FUE punches and devices and consolidated descriptive information for each to create textual and visual guides. No single punch shape or device may suit all cases; thus, it is important to know the best uses and limitations of each. CONCLUSION The surgeon should have a comprehensive knowledge base of available punch shapes and devices and understand the advantages and disadvantages of each. It is also beneficial to have an in-depth knowledge of skin properties and follicular unit structure. Ultimately, understanding the dynamics behind punch excision will enhance the FUE technique. [ABSTRACT FROM AUTHOR]

BACKGROUND Follicular unit excision (FUE) and follicular unit transplantation using strip surgery (FUT) are the dominant graft harvest methods in hair transplantation. The increase in the demand for FUE has reignited the debate of the relative superiority of the 2 methods. OBJECTIVE To present a critical comparison of FUE and FUT graft harvesting techniques. MATERIALS AND METHODS Search of PubMed, trade publications, and printed references. RESULTS Follicular unit excision and FUT methods provide high-quality grafts, but differ in their scarring patterns of the donor region. Follicular unit transplantation results in a linear scar, whereas FUE produces punctate scars that are typically easily concealed. Distinct subgroups of hair transplant patients are eligible for FUE, FUT, or both procedures. CONCLUSION Both FUE and FUT are equally effective in generating high-quality grafts. This detailed evaluation of the FUT and FUE procedures will assist hair restoration surgeons make informed decisions about the best approach for their patients. [ABSTRACT FROM AUTHOR]

BACKGROUND Eyebrow hair loss is usually a primary feature of frontal fibrosing alopecia (FFA), which causes significant distress to patients and consequently seek medical help. Eyebrow hair transplantation is a well-accepted and aesthetically successful treatment, but there is a lack of information about the short- and long-term results in this subset of patients. OBJECTIVE To report the short- and long-term eyebrow hair transplantation results in patients with FFA. PATIENTS AND METHODS Ten patients diagnosed with FFA underwent eyebrow hair transplantation. The transplanted hairs were harvested from nonaffected follicles of the occipital scalp skin. On average, 120 to 270 single-hair follicles were implanted per eyebrow. RESULTS Eighty percent of patients achieved excellent hair growth at 6- to 12-month follow-up and satisfactory short-term results (<2 years). However, majority started losing the transplanted hairs after 3 to 4 years. Only 1 patient did not lose transplanted hair in the long-term follow-up (>4 years). CONCLUSION The results of eyebrow hair transplantation in FFA patients are variable and contentious. The short-term outcome is satisfactory, but in most patients, a progressive loss of transplanted hairs can be expected. Therefore, FFA patients inquiring about eyebrow transplantation should be advised about the high possibility of hair graft loss over time. [ABSTRACT FROM AUTHOR]

Ergonomics in hair transplantation is a key to success for both novice and experienced hair transplant surgeons. We identified the following ergonomics considerations as they pertain to hair transplantation: (1) operating room layout and organization, (2) instrumentation and workflow, (3) patient positioning, and (4) physician mechanics and posture. [Extracted from the article]

BACKGROUND: Studies highlighting the role of hair follicles (HFs) in wound healing have raised the challenge of bringing this knowledge to clinical applications. A successful translation is the transplantation of scalp HFs into chronic wounds to promote healing. OBJECTIVE: To characterize scar formation and hair growth in nonhealing ulcers after transplantation. PATIENTS AND METHODS: Nonhealing ulcers were treated with hair transplantation to promote wound healing. Hair follicles were harvested from the patient's scalp and inserted into the wound bed. Wound repair and hair growth were assessed clinically. Further analyses were performed in situ, using biopsies from the central and peripheral scar. RESULTS: Rapid wound closure and differences of scar quality and hair growth between the central and peripheral wound areas were observed: the periphery healed with no hair shaft survival and an almost scarless appearance, the center healed with a fibrotic scar, with some hair shaft growth. In situ analyses revealed differences in dermal remodeling and collagen formation between central and peripheral scar areas. CONCLUSION: Besides confirming the effectiveness of this therapy to promote wound healing in human skin, location-dependent disparities in scar quality and hair growth raise the intriguing question whether they are due to clinically important differences in mechanical forces and/or wound microenvironments between ulcer center and periphery. [ABSTRACT FROM AUTHOR]

By using a motorized follicular unit extraction (FUE) device originally developed for hair restoration surgery, we easily harvested vellus hair grafts from the abdominal area and made holes in the vitiligo patch for graft transplantation. Several surgical techniques have been developed, such as mini punch grafting, suction blister epidermal grafting, split-thickness skin grafting, hair follicle transplantation, and cellular grafting, such as noncultured epidermal suspension grafting and cultured melanocyte grafting. Further studies are needed to compare outcomes of vellus hair graft with those of nonfollicular epidermis punch graft on the same area of a vitiligo lesion. [Extracted from the article]

The distal end of the flap is then folded and adjusted to the posterior border of the defect by trimming the flap and affixing it with individual subcutaneous sutures followed by subsequent superficial sutures (Figures 2C and 3B). In summary, the anteriorly pedicled retroauricular flap represents a strong alternative to other techniques, such as the retroauricular flap or the temporoparietal fascial flap, forthe reconstruction of large defects of theexternal ear. Well-established reconstructive techniques of the ear include primary closure, wedge excisions, skin grafting, advancement flaps, rotation flaps, island pedicle flaps, and the retroauricular pedicled flap. [Extracted from the article]

In this article, we present a patient who demonstrated overcorrection after grafting autologous fat in the upper eyelid for 3 years. The transferred fat tissue, which was harvested from behind the scar tissue, could be clearly demarcated from the orbital fat depot by the orbicularis oculi muscle and the orbital septum. Long-TermHistologicalFindingsofAutologousFatGraftingintheUpperEyelid A utologous fat transplantation has become a safe and convenient method in the treatment of facial volume deficits caused by congenital and acquired conditions, but the long-term survival rate of fat grafts is unpredictable and unsatisfactory. [Extracted from the article]

This explains whypatientsareusuallypresentedwithmildfrontoparietal hairline recession, an increased proportion of vellus hairs, anoveralldecreaseinthehairshaftdiameter(60.8mm),and a decrease in hair density (136 hairs/cm 2), which are all hallmarks of androgenetic alopecia (AGA). The objective of this trial was to determine the efficacy and safety of hair transplantation using the follicular unit long hair technique (FUL) in patients with EIA. Here, we reported for the first time the efficacy and safety of hair transplantation in women suffering from EIA.Asignificantimprovementofscalpcoveragewasobserved after 1 single session of FUL hair transplantation. [Extracted from the article]

(A) Forehead flap from contralateral eyebrow was designed bearing glabrous skin and hair from frontal hairline. (4) The hair angle and direction are particularly important in the eyebrow; therefore, meticulous orientation of the flap is the main factor for a successful recreation of the eyebrow with natural results. [Extracted from the article]

Discussion Hypothermic preservation medium solution with ATP may serve as a superior storing solution for hair follicle grafts, especially for cases with extended graft storage. Surgeons have frequently considered the possibility that holding solutions for hair grafts during transplantation may affect graft survival. [Extracted from the article]