BACKGROUND: Laser hair removal treatment for hairlines with an unsatisfactory appearance often leads to an unnatural appearance; however, few studies have reported treatment outcomes.
OBJECTIVE: To explore the satisfaction rate of laser hair removal involving the hairline.
METHODS: Retrospective analysis.
METHODS: Data from 5 clinical institutions.
METHODS: Patients (915; 630 female and 285 male) who underwent laser hair removal.
METHODS: Issues associated with hair removal were classified, and their proportions were calculated. Hair transplantation was performed to improve the appearance of different hairline issues.
METHODS: Relevant indicators of hair transplantation and postoperative effects.
RESULTS: Overall, 82 patients were unsatisfied with their hairline appearance; of these patients, 58 underwent hair transplantation to improve the hairline. Additionally, demographic statistics showed that 68% and 32% of patients were in the 20 to 30 and 30 to 40 years age groups, respectively; there were no patients in the 40 to 50 years age group. Among female patients who underwent hair transplantation, 25% had a poor hairline position, 64% had a stiff hairline appearance, and 11% experienced both issues. Among male patients, 50% had a stiff hairline appearance, 28% had temporal absence, and 22% experienced both issues. Surgical treatment included moving the hairline forward and rebuilding the frontal curves. All patients were satisfied with hair transplantation outcomes.
CONCLUSIONS: Laser hair removal can result in diverse types of unnatural hairlines. Hair transplantation has been proven to effectively improve the aesthetic appearance of the hairline.

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BACKGROUND: The issue of hair growth on reconstructed ears has been a matter of concern for both patients and surgeons, despite the notable progress made in microtia reconstruction technology in recent times.
OBJECTIVE: This study aims to present the practical implementation of long-pulsed 800-nm diode laser depilation technology in the field of auricular reconstruction. Furthermore, it seeks to establish a comprehensive and standardized protocol for utilizing lasers in the reconstruction of microtia ears.
METHODS: A total of 965 patients (comprising 1021 ears) diagnosed with congenital microtia underwent treatment using 800-nm long-pulsed diode laser depilation. The participants received 1-3 treatment sessions with intervals of 25-30 days. To assess the effectiveness of the treatment, two independent observers compared photographs and measured the reduction in terminal hair count before and after the final session. Clinical outcomes were evaluated using VAS questionnaires, and any adverse events were diligently recorded.
RESULTS: The findings indicated that the utilization of the long-pulsed 800-nm diode laser was both safe and efficient in achieving hair removal during microtia ear reconstruction. As additional sessions were conducted, pain scores demonstrated a decline, while adverse reactions remained minimal.
CONCLUSIONS: This is a retrospective single-institution study.
CONCLUSIONS: The application of a long-pulsed 800-nm diode laser has been proved to be a safe and effective method for removing hair during the process of microtia ear reconstruction, involving the use of a tissue expander and autologous costal cartilage. To achieve satisfactory results in hair removal, it was found necessary to repeat the shots procedure two to three times.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

BACKGROUND: Long-hair follicular unit excision (LHF) is gaining popularity, especially for hairline restoration, because it helps avoid hair removal in the donor area and provides better immediate postoperative results.
OBJECTIVE: This study aimed to assess the postoperative clinical outcomes of LHF for hairline restoration.
METHODS: Data from 248 patients (223 women and 25 men) who underwent hairline restoration with LHF between September 2018 and June 2022 were analyzed, and they were followed up immediately and 9 months postoperatively. The complications and survival rate of long-hair grafts were assessed. Patient postoperative satisfaction was assessed using a 5-Point Likert Scale. The Generic Quality of Life Inventory-74 (GQOLI-74) assessed the quality of the postoperative life.
RESULTS: The planned extraction density was set at 15-25 FU/cm2. The mean number of total extracted hair grafts, transection rate in the extraction area, and extraction time were 1970 ± 124 FU, 3.9 ± 0.2%, and 3.2 ± 0.8 h, respectively. The hairline implantation density was set at 50-70 FU/cm2. The mean number of total transplanted hair grafts was 2031 ± 371 FU; the implant time was 3.8 ± 1.9 h. No serious complications occurred within 7 days postoperatively. The mean graft survival rate was 93.1 ± 1.3% at 9 months postoperatively. All patients were satisfied with the immediate postoperative results, and most were satisfied with the 9-month outcomes (mean overall satisfaction score: 4.7). The scores of physical function, psychological function, social function and material life function after operation were higher than those before operation (p < 0.0001).
CONCLUSIONS: Hairline restoration with LHF could enhance the cosmetic outcomes and be widely used in clinical practice.

BACKGROUND: Nosocomial infections caused by Serratia marcescens mostly occurred in pediatrics and it was very rarely reported after adult surgery. Here, an intracranial abscess caused by Serratia marcescens was reported. We report a rare case of a postoperative intracranial abscess caused by Serratia marcescens in a 63-year-old male patient with a left parietal mass. The patient underwent resection of the mass on June 1, 2022, and the postoperative pathology revealed an angiomatous meningioma, WHO I. He then experienced recurrent worsening of right limb movements, and repeated cranial CT scans showed oozing blood and obvious low-density shadows around the operation area. Delayed wound healing was considered. Subsequently, a large amount of pus was extracted from the wound. The etiological test showed that Serratia marcescens infection occurred before the removal of the artificial titanium mesh. Antibiotics were initiated based on the results of drug susceptibility tests. At present, the patient is recovering well and is still closely monitored during follow-up.
CONCLUSIONS: It is rare for Serratia marcescens to cause brain abscesses without any obvious signs of infection. This report provided in detail our experience of a warning postoperative asymptomatic brain abscess caused by an uncommon pathogen.

The long-pulse alexandrite laser uses Cr3+:BeAl2O4 crystals as the activation medium and has a 755nm wavelength and millisecond pulse duration. The long-pulse alexandrite laser has been utilized for hair removal, vascular lesions, pigmented lesions, and other conditions because melanin and hemoglobin in the skin, subcutaneous tissues, and skin appendages can specifically absorb this type of laser. To serve as a guide and source of inspiration for the clinical use of this type of laser, we review the present research status and advancement of the long-pulse alexandrite laser in the treatment of the aforementioned categories of disorders.

Use of scalp skin for facial organ reconstruction represents a mainstream procedure for organ reconstruction. In most cases, adequate amounts of skin can be obtained by using tissue expanders, but harvesting sufficient scalp tissue in patients with low hairlines is challenging. Hair follicular unit extraction (FUE) is one approach to resolve this problem. With FUE, hair follicles are removed from the scalp skin, which can then be prepared as a donor site to obtain sufficient amounts of hairless skin.
To evaluate the safety and efficacy of FUE when combined with an expanded scalp flap for facial organ reconstruction.
Patients with low hairlines requiring facial organ reconstruction were selected for this study. The area of skin extension and hair removal were determined prior to surgery, a process which was performed in three stages. Stage I consisted of hair follicle removal using the FUE technique at the donor site. Stage II involved expander implantation using water injections. In Stage III facial organ reconstruction was completed.
With the use of the FUE technique, hair follicles from the donor scalp were thoroughly removed and the donor scalp tissue was successfully expanded. Postoperatively, no evident scar formation at the reconstruction site or contracture of the expanded flap was observed. All patients were satisfied with the outcome of their reconstruction procedure.
FUE provides a means for hair follicle removal from the donor site and can be employed to achieve a safe and effective procedure for facial reconstruction in patients with low hairlines.

This study aimed to investigate the safety and efficacy of depilation with intense pulsed light (IPL) in congenital microtia patients during their reconstruction treatment. The hairy skin was treated with the M22TM system (Lumenis, German) using a filter of 695 to 1200 mm. A contact prob with a window of 15 cm × 35 mm or 8 cm × 15 mm was used at a radiant setting of 14 to 15 J/cm2 in the non-expander group and 13 to 14 J/cm2 in the expander group, both in a single pulse mode. The efficiency index of hair removal was classified based on the percentage of hair density reduction as excellent (>75%), good (50-75%), fair (25-50%), poor (<25%). The depilation effect was compared between the 2 groups, and any adverse effects were evaluated. A total of 159 patients were included, with 93 patients in the expander group and 66 in the non-expander group. The reduction of the hair density in the expander group after 3 treatments was higher than that in the non-expander group [82.98 (73.47-89.09)% vs 77.84 (71.50-85.34)%; P < .05, Wilcoxon rank-sum test], as well as the efficiency [excellent cases 68 (73.12%) vs 37 (56.06%); P < .05, Chi-square test]. Four cases of folliculitis, 3 cases of blisters, and no instance of expander exposure and cartilage absorption were observed in this study. Hair removal with IPL is a safe and effective photo-epilation method during all stages of ear reconstruction using tissue expander. Depilation in the skin expansion period resulted in better outcomes after 3 treatments, although after 5 treatments no difference between the 2 groups was observed.

Background: The optimal timing of laser epilation with expanded forehead flaps in facial defect reconstruction remains undetermined. Objective: To compare the efficacy and safety of hair removal during or after flap expansion. Methods: This prospective exploratory study included 15 (11 women and 4 men, 16.47 ± 16.331 years of age) and 26 (19 women and 7 men, 10.69 ± 10.899 years of age) patients who underwent 755 nm long-pulsed alexandrite laser epilation during flap expansion and after surgery, respectively. Facial reconstruction was performed in these patients because of congenital melanin nevus, scar or port-wine stains. Evaluation included hair reduction rate, patient satisfaction, and adverse events. Results: The median number of laser sessions for hair removal during flap expansion was significantly lower than that after surgery (2.00 vs. 3.00, p < 0.01), and the hair reduction rate was also significantly higher during flap expansion (79.5% ± 21.93% vs. 68.3% ± 17.44%, p < 0.05). No severe adverse events were reported. Conclusion: Laser hair removal is safe and efficient when performed both during flap expansion period and after surgery, but its efficacy was significantly higher, and fewer sessions were required when performed during tissue expansion. Clinical trial registration information: ChiCTR1900026090.

Owing to the greater absorption affinity for lipo-rich tissue than water, the 1210 nm laser is a promising candidate for transcutaneous lipolysis in the near-infrared band. However, fat reduction is limited because laser therapy may yield thermal injury of normal tissue. A new protocol to incorporate multipulsed cryogen spray cooling is beneficial to improve the lipolysis effect, and the parameters of laser and cooling can be optimized via skin histopathological analysis.
A murine in vivo model of inguinal tissue of SD rats was established to test the effectivity of transcutaneous lipolysis protocol by R134a multipulsed spray cooling assisted 1210 nm laser irradiation. Tissue response of lipolysis with/without cooling 10 days post the treatment was evaluated by histopathological analysis of skin samples stained with hematoxylin-eosin (HE), through which safe and effective parameters for lipolysis were determined.
From histopathological analysis of the inguinal tissue of SD rats irradiated by the 1210 nm laser alone, the optimal durations are respectively 7 and 3 s (seconds) for low-dosage (6 W) and high-dosage (9 W) therapy, with pronounced lipolysis effect and minimum injury of skin tissue. The multipulsed spray cooling by R134a with a pulse duration of 10 ms (milliseconds), a pulse delay of 2000 ms, and a pulse number of 5 can be introduced to assist the 1210 nm laser therapy with a power of 9 W and a duration of 7 s to achieve desirable fat liquefaction while keeping the complete structure of skin tissue as well as esthetic-related beneficial effects of hair removal and skin rejuvenation.
Excellent lipolysis effect can be achieved via R134a multipulsed spray cooling assisted high-dosage 1210 nm laser irradiation with reasonably matched laser and cooling parameters. The protocol is as follows: Start MP-CSC for one cycle, and then fire the laser with specific power and duration, while keeping MP-CSC accordingly. This new protocol may promote the safe and effective clinical implement of transcutaneous laser lipolysis in body contouring.