BACKGROUND: Follicular unit hair transplantation has greatly elevated the results of eyebrow restoration. However, unnatural and unbeautiful-looking results are still often seen after the surgery.
OBJECTIVE: This study focused on poor eyebrow transplantation, discussed its possible reasons, and offered refined proposals.
METHODS: A retrospective analysis was performed on 100 patients who were dissatisfied with the results of eyebrow grafting and came to our department from 2011 to 2021. Demographic characteristics, primary disease, and clinical data were objectively summarized and analyzed for these patients.
RESULTS: The patients\' medical charts and photographs were analyzed and summarized into the following outcomes: Thirty-six patients (36%) had sparse eyebrows. Forty-one patients (41%) had eyebrows with inhomogeneous density and disordered growth direction. Eleven patients (11%) did not have single-hair grafting. Seven reconstructed eyebrows (7%) had a poor connection with the remaining eyebrows. Five new eyebrows (5%) had inconsistent hair characteristics with the original eyebrows. Lower hair survival rates, insufficient understanding of naturally beautiful eyebrows, and inadequate communication with patients were the main reasons for poor outcomes.
CONCLUSIONS: Good reconstructed eyebrows should have a high hair survival rate, and hair growth direction and characteristics should also be consistent with the natural eyebrow to achieve ideal surgical effects.
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: Hair transplantation, particularly through follicular unit extraction (FUE), can lead to postoperative complications, such as numbness, itching, and pain in donor areas, primarily because of delayed wound healing. Efficient management of donor-site healing is crucial to mitigate these complications and improve overall patient outcomes.
OBJECTIVE: This study aimed to assess the efficacy of hair follicular-derived microtissue (HFMT) in promoting wound healing and alleviating postoperative complications in donor areas after FUE hair transplantation.
METHODS: Perifollicular tissue obtained during the trimming phase of hair transplantation was processed into HFMT and analyzed for its properties using histological and molecular techniques. In a single-blind, split-scalp study involving 98 participants, Group A received HFMT or mupirocin, whereas Group B received HFMT or no treatment. Dermatoscopic images were captured postoperatively, and visual analog scale scores were used to evaluate pain, itching, and numbness.
RESULTS: HFMT-treated donor sites in Group A demonstrated a significantly higher wound closure ratio on postoperative day 3 than mupirocin-treated sites. Pain scores for HFMT-treated sites were consistently lower on postoperative days 3, 5, and 7. Similar trends were observed for itching scores. Group B exhibited outcomes comparable with Group A.
CONCLUSIONS: The application of HFMT homogenates effectively accelerated wound healing and alleviated donor-site complications after FUE hair transplantation.

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.

BACKGROUND: Recipient-area perifollicular erythema (RPE) may delay graft growth after hair transplantation. However, there is currently a lack of observational clinical studies of RPE.
OBJECTIVE: To study the clinical features and risk factors associated with RPE while analyzing its correlation with graft growth.
METHODS: We conducted a multicenter retrospective cohort study between June 2020 and January 2023.
RESULTS: A total of 1090 participants were included, 178 (16.33%) showed mild RPE, 56 (5.14%) showed moderate RPE, and 10 (0.92%) showed severe RPE. Patients with RPE had severe hair shaft shedding (P < 0.001) and a lower survival rate (P < 0.001) of grafts. Logistic regression analysis showed that folliculitis is a significant risk factor for mild RPE (OR 6.061, 95% CI 3.343-10.991, P < 0.001) and moderate RPE (OR 3.397, 95% CI 1.299-8.882, P = 0.013). Besides, untimely first postoperative hair washing was associated with the development of moderate RPE (OR 0.724, 95% CI 0.553-0.947, P = 0.018) and severe RPE (OR 1.553, 95% CI 1.156-2.086, P = 0.003).
CONCLUSIONS: RPE is a postoperative complication closely related to high hair shaft shedding proportion and low graft survival rate. Both postoperative folliculitis and untimely first postoperative hair washing may induce the occurrence of RPE.
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: Hair transplantation surgery requires the efficient completion of hair follicles and thus appropriate hair implantation needles. The objectives of this study were to evaluate the effectiveness and feasibility of self-made hair implantation needles using injection needles and evaluate the speed of different hair implantation methods.
METHODS: Four patients were randomly assigned to four groups. A gem knife pre-punching planting method was used for the patient in Group A, while Group B received immediate implantation after punching with ordinary injection needles, Group C was treated with synchronized punching and planting using hair implanters, and Group D was treated with a self-made hair implantation needle. The speed of the different implantation methods for single and double hair follicles and the differences between the planting of single and double hair follicles were assessed.
RESULTS: Group D was found to have the fastest hair planting speed for both single and double hair follicles, followed by Groups C and A, with the slowest speed observed in Group B. Groups A and B were associated with significantly lower speeds of double hair planting than single hair planting, There was no significant difference between Groups C and D.
CONCLUSIONS: The self-made hair implantation needle is a novel and efficient tool for synchronized punching and planting. It has a faster planting speed and does not require assistance.
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 .

OBJECTIVE: Cicatricial alopecia not only affects patients\' appearance but also has negative effects on their physical and mental well-being, as well as their daily lives. Therefore, it is essential to provide proactive treatment to patients.
OBJECTIVE: To explore the clinical effects of autologous follicular unit extraction (FUE) transplantation in the treatment of secondary scarring alopecia caused by burn, and to evaluate its effectiveness.
METHODS: A retrospective observational study has been conducted, which included 41 patients with secondary scarring alopecia caused by burn. All patients underwent initial autologous FUE hair transplantation surgery, and the occurrence of postoperative complications was monitored. Patient satisfaction was evaluated after 12 months post-surgery.
RESULTS: Satisfaction assessments were conducted for all 41 patients. Out of the total, 31 individuals expressed being very satisfied, 7 individuals reported being satisfied, and 3 individuals indicated being not very satisfied. Among the patients, 3 experienced complications, including herpes in the donor area for one patient, temporary hair loss for another patient, and thick scab for the third patient.
CONCLUSIONS: FUE hair transplantation yields positive results for secondary scarring alopecia caused by burn. It offers natural hair growth patterns, minimal trauma, quick recovery, high patient satisfaction, and few complications.

Androgenic alopecia is a type of hair loss condition that is influenced by both genetic and environmental factors. This study aimed to investigate the effectiveness of combining hair transplantation with platelet-rich plasma injection for treating androgenic alopecia. From June 2019 to September 2021, a total of 147 patients with androgenic alopecia were selected and treated by our department. Out of these, 72 patients were assigned to the treatment group and received hair transplantation along with platelet-rich plasma treatment. The remaining 75 cases constituted the control group, receiving only hair transplantation. Clinical data was obtained by reviewing the patients\' medical records and case reports. The area of hair loss in the treatment group was significantly smaller than that in the control group. The score of the hair pulling test in the treatment group was significantly lower than that in the control group. The hair regeneration score in the treatment group was significantly higher than that in the control group. After treatment, the total area of skin lesions in the treatment group was significantly reduced compared to the control group. There was a statistically significant difference between the two groups. Our study indicates that combining hair transplantation with platelet-rich plasma is superior to hair transplantation alone for the treatment of androgenic alopecia. This combination therapy shows promising potential for clinical applications.

OBJECTIVE: To explore the clinical effects of autologous follicular unit extraction (FUE) transplantation in the treatment of secondary scarring alopecia caused by infections, and to evaluate its effectiveness.
METHODS: A retrospective observational study has been conducted, which included nine patients with secondary scarring alopecia caused by infections. All patients underwent initial autologous FUE hair transplantation surgery, and the occurrence of postoperative complications was monitored. Patient satisfaction was evaluated after 12 months post-surgery.
RESULTS: At the follow-up, postoperative satisfaction was 88.9% in nine patients, with only one case of postoperative infection and no incidence of skin necrosis, significant bruising and swelling, unnatural appearance or temporary hair loss.
CONCLUSIONS: Autologous FUE hair transplantation is an effective method for treating secondary scarring alopecia caused by infections. This procedure is minimally invasive, resulting in high patient satisfaction and minimal complications postoperatively.

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