Introduction: One of the most frequently performed anti-aging surgical procedures is thread facelift. Since the 2010s, thread lifts using absorbable polydioxanone (PDO) thread were developed and have become increasingly popular. This research aims to identify the changes in and the mechanisms of absorbable thread-lifting components, namely, PDO (polydioxanone) and PCL (polycaprolactone), with varied absorption periods in the body.Methods: Four different types of threads, namely, single-stranded thread, 4-stranded thread, 12-stranded thread, and barbed Cog thread, were used for each component.Histological changes in the thread and neighboring tissue of rat model were investigated for 2-week interval, and PCR was conducted for genes related to fibroblast proliferation including type 1α1 collagen, type 3α1 collagen, transforming growth factor beta 1 (TGF-β1).Results: An increase in the collagen formation in all types of PDO and PCL groups was observed during the first 12 weeks and decreased afterward. Collagen formation decreased later in the PCL thread group significantly than the POD group. PCL thread remained logner in the tissue for over a year regarding POD requiring around 24 weeks of absorption-degradation. A larger surface area between the thread and the tissue induces a greater response in the tissue, resulting in an increase in inflammatory cells, myofibroblasts, and fibroblasts. Results showed a similar pattern of increase in type 1α1 collagen and TGFβ in the PDO thread group. This suggests that TGFβ signal transduction leads to fibroblast proliferation that stimulates collagen formation and tissue re-formation. In contrast, only type 3α1 collagen increased in the PCL thread group. Conclusion:More collagen formation and tissue responses are induced by PCL thread, remaining longer in the tissue than PDO, leading to more tissue tightening effects that is one of the most important points of face lifting. Morphological comparison of threads shows that not only an increase in surface area between thread and tissue but also multi-strand increase tissue response, which in turn increases tissue maintenance effects.

Background This study aimed to evaluate the efficacy and safety of a topical antioxidant cream containing tocotrienol after 1064-nm picosecond neodymium-doped yttrium aluminum garnet (Nd:YAG) laser treatment for environment-induced skin pigmentation.Methods A split-face study was conducted between December 2020 and March 2021 in 26 patients (25 women and one man) who were treated with a 1064-nm picosecond Nd:YAG laser. On the right side of the face, an antioxidant cream containing tocotrienol was applied after picosecond laser treatment, and on the left side, only picosecond laser treatment was performed. We compared the right and left sides of the face at 4 weeks after laser treatment using an automatic skin analysis device to investigate skin pigmentation. The melasma severity scores of the two sides were evaluated before and 4 weeks after picosecond laser treatment.Results The skin pigmentation score showed a significant difference between pretreatment and 4 weeks after picosecond laser treatment on both sides of the face (P<0.001), and there was a significant difference in skin pigmentation score improvement between the right and left sides (P<0.001). The melasma severity score showed a significant difference on the right side between pretreatment and 4 weeks after laser treatment (P<0.001), but there was no significant change on the left side (P>0.05).Conclusions Our results show that, for the treatment of environment-induced skin pigmentation, the application of a tocotrienol-containing antioxidant cream after 1064-nm picosecond laser treatment can provide good results without any complications.

Background: Pilonidal sinus, occurring in 7% of the population, is a disease found in the cleavage of the buttocks, typically in young males after puberty. This study explored the utility of the leaf flap, a unilobed fasciocutaneous transposition flap, as a reconstructive method for treating pilonidal sinus on the sacrococcygeal area.Methods: We present cases of eight patients with pilonidal sinus who underwent unilobed fasciocutaneous transposition flap surgery. Patients complaining of an abscess in the sacrococcygeal region were initially treated with a minimal incision to drain the abscess, and 14 days of antibiotics administration. Afterwards, the patients were re-evaluated at the outpatient clinic and scheduled for a leaf flap procedure 4 weeks after drainage. Hospitalization, the time required for full activity, and complication rates were recorded.Results: Minor postoperative complications were observed in one patient (12.5%). The patient required re-suturing of his wound due to an infection and wound dehiscence. The mean hospitalization was 10 days (range, 5–23 days), and the period required to return to daily activities was 4 weeks.Conclusion: The leaf flap procedure is recommended because it is a relatively easy method for surgeons, and also because the flap has abundant perfusion. This surgical method was used as the first treatment of choice for sacrococcygeal pilonidal sinus, with the advantages of less patient discomfort, fast healing of the site and short hospitalization. Our results support the leaf flap surgery as a favored treatment for pilonidal sinus.