Background Necrosis of frontotemporal skin and/or the ipsilateral scalp with subsequent alopecia after hyaluronic acid (HA) filler injection into the temple are rare and newly reported complications, with superficial temporal artery (STA) embolization suspected as the major pathological mechanism. The main treatment currently is intralesional hyaluronidase (HAase) injection, but the effectiveness of percutaneous superficial temporal arterial HAase injection still lacks consensus. Objectives The aim of this study was to investigate the effectiveness of superficial temporal arterial HAase injection in dissolving HA filler-induced necrosis of frontotemporal skin and/or the ipsilateral scalp with subsequent alopecia. Methods In this study, 5 recent clinical cases with necrosis of frontotemporal skin and/or the ipsilateral scalp with subsequent alopecia after HA filler injection into the temple were analyzed retrospectively. The patients underwent HAase injection via STA combined with adjunctive treatments, and the clinical progress was observed. Results The significant improvement was observed in terms of necrosis of frontotemporal skin and the ipsilateral scalp after treatment and the patients were relieved of their clinical symptoms. Alopecia occurred approximately 1 to 2 weeks after HA filler injection, and the well-defined alopecia areas were formed about 15 to 20 days after HAase injection. Patients were subsequently followed for 3 to 6 months. During follow-up, the skin lesions of all patients were restored to near normal appearance. Hair regrowth was observed 2 to 3 months after HAase treatment and the hair density nearly reached the normal level 3 to 4 months later. Conclusion Percutaneous superficial temporal arterial HAase injection is an effective treatment option for HA filler-induced necrosis of frontotemporal skin and/or the ipsilateral scalp with subsequent alopecia.

Pathological scar is a classic problem in plastic and reconstructive surgery. Although the researches on pathological scar have been conducted for decades, the way to go to address this thorny problem still remains challenging. To the best of our knowledge, few bibliometric analysis concerning pathological scar have been reported. In this study, we set out to employ bibliometric and visual analysis to offer research status and trends of pathological scar over the period 2001–2021. All publications covering pathological scar during 2001–2021 were retrieved and extracted from the Web of Science database. We applied VOSviewer software to evaluate the keywords and research hotpots, and the online tool (http://bibliometric.com/) was used to carried out the publication trends analysis. A total of 2221 pathological scar‐related articles were identified over the period 2001–2021. China is the country which had the largest volume of publications (819, 36.87%), followed by the United States (416, 18.73%), Japan (144, 6.48%), Korea (142, 6.39%), and England (118, 5.31%). Among the institutions and journals, Shanghai Jiao Tong University (167) and Wound Repair and Regeneration (85) accounted for the most papers related to pathological scar, respectively. Professor Bayat A, who had the most citation frequency (2303), made great contribution in pathological scar field. “Fibroblast”, “expression”, and “proliferation” were identified as the pathological scar research hotspot through analysis of the keywords. In terms of publication, China ranked first all over the world, but the numbers of publication are inconsistent with the citation frequency, ranking first and second, respectively. Shanghai Jiao Tong University and journal Wound Repair and Regeneration stand for the highest level of research in this field to a certain extent. In the early stage, the research focus was mainly on the prevention, treatment, and risk factors for recurrence of pathological scar from cases. In the later stage, the research focus was on the comprehensive management, in which the mechanism research was in‐depth to the molecular and gene level.

Background Although micro-plasma radiofrequency (MPR) treatment has a significant effect on scars, patients require anesthesia to relieve the significant discomfort it produces. Whether anesthesia impacts efficacy is unclear. Objective To evaluate the effect of different anesthesia on MPR for hypertrophic scars. Methods A retrospective cohort study involving 101 people was conducted to investigate the effectiveness and safety of general and topical anesthetics for the treatment of MPR scars. The primary measures of outcome were the Vancouver Scar Scale (VSS) scores before the first treatment and six months after the last treatment, as well as the Visual Analogue Scale (VAS) scores on the day and the day after the final treatment. Results The differences in scar pigmentation, vascularity, and overall VSS scores were higher in the general anesthesia group than in the surface anesthesia group. Patients in the general anesthesia group had a lower pain level than those in the surface anesthesia group. After adjusting for confounding factors and propensity score matching, the outcome of VSS and VAS scores was stable. There was no statistical difference in the adverse effects and satisfaction between the two groups. Conclusion General anesthesia, as opposed to surface anesthesia, may not only ensure safety but also increase the effectiveness of MPR and lessen postoperative pain in the treatment of hypertrophic scars.

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