Chinese Journal of Plastic and Reconstructive Surgery最新文献

{"title":"TcPO2 and TcPCO2 monitoring for free flap perfusion assessment","authors":"Fangfang Liu ,&nbsp;Nannan Han ,&nbsp;Huimin Yuan ,&nbsp;Lei Wang ,&nbsp;Jinxiu Dong ,&nbsp;Yanfen Ding ,&nbsp;Min Ruan ,&nbsp;Youguo Ying","doi":"10.1016/j.cjprs.2025.04.001","DOIUrl":"10.1016/j.cjprs.2025.04.001","url":null,"abstract":"<div><h3>Background</h3><div>Free flap transplantation has emerged as a prevalent technique in reconstructive surgery for patients with oral cancer. Postoperative monitoring of flap perfusion is critical for flap survival, necessitating early detection and timely intervention. Developing a monitoring approach that is highly sensitive, specific, non-invasive, continuous, and cost-effective is crucial for accurately assessing flap perfusion and informing clinical decisions.</div></div><div><h3>Methods</h3><div>From April 2024 to December 2024, 20 patients with oral tumors requiring flap transplantation were enrolled at the Ninth People’s Hospital affiliated to Shanghai Jiao Tong University School of Medicine. Continuous monitoring of various free flaps was performed utilizing a transcutaneous blood gas analyzer, both before and after surgery. This approach allowed for real-time measurement of transcutaneous partial pressure of oxygen (TcPO₂) and transcutaneous partial pressure of carbon dioxide (TcPCO₂), facilitating the evaluation of perfusion dynamics across various free flap types.</div></div><div><h3>Results</h3><div>After free flap transplantation, a reduction in blood supply resulted in a rapid decline in TcPO₂ (to below 10 ​mmHg), accompanied by a gradual increase in TcPCO₂, peaking at 135 ​mmHg. Following vascular anastomosis and blood flow restoration, TcPO₂ and TcPCO₂ exhibited opposite trends. Statistical analysis revealed no significant differences in TcPO₂ and TcPCO₂ measurements among the various flap types (<em>P</em>&lt;0.05), indicating a consistent pattern of change across all flaps.</div></div><div><h3>Conclusion</h3><div>The transcutaneous blood gas analyzer proves to be a reliable method for monitoring free flap perfusion. Dynamic changes in TcPO₂ and TcPCO₂ effectively reflect blood supply status, enabling early detection of vascular compromise and potentially enhancing flap preservation outcomes.</div></div><div><h3>Trial registration</h3><div>ChiCTR, ChiCTR2400086395. Registered March 4, 2024. Prospective registration. <span><span>https://www.medicalresearch.org.cn/&amp;nearr;ChiCTR2400086395</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":65600,"journal":{"name":"Chinese Journal of Plastic and Reconstructive Surgery","volume":"7 3","pages":"Pages 133-139"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstruction of chronic nerve injuries using artificial nerve conduits: A case series","authors":"Lidiya Sorogina ,&nbsp;Tatyana Verbakh ,&nbsp;Vladimir Malishevsky ,&nbsp;Ivan Byrke ,&nbsp;Yanis Chakhchakhov ,&nbsp;Olesya Startseva ,&nbsp;Mark Gabriyanchik","doi":"10.1016/j.cjprs.2025.04.002","DOIUrl":"10.1016/j.cjprs.2025.04.002","url":null,"abstract":"<div><div>Traumatic peripheral nerve injuries are a major contributor to long-term disability, accounting for nearly half of all peripheral nervous system disorders. Although autologous nerve grafting remains the clinical gold standard, it is limited by donor-site morbidity and often fails to achieve full functional recovery. Biodegradable collagen conduits have emerged as an appealing alternative, providing a scaffold for directed axonal growth without requiring graft harvest. We reported three cases of chronic nerve injuries (6–12 months post-trauma): two involving 2.0–3.5 cm ulnar nerve defects in the forearm and one with a 2.5 cm median nerve defect at the wrist. Under microscopic guidance, each defect was bridged with a tubular type I collagen conduit secured by epineurial sutures, followed by standardized physiotherapy and sensory reeducation. At 12–18 months of follow-up, all patients demonstrated near-complete sensory recovery—two-point discrimination and Semmes-Weinstein thresholds returned to ≤6 mm—and motor function improved to Medical Research Council grades 4–5, restoring fine dexterity and grip strength. Patient-reported measures indicated marked reductions in neuropathic pain and paresthesia. No conduit-related adverse events or neuroma formation were observed. This case series highlights the potential of collagen-based conduits to promote robust axonal regeneration and functional restoration even in delayed presentations. By eliminating donor-site morbidity and simplifying the reconstructive procedure, conduit-assisted repair offers a less invasive, reproducible alternative to autologous grafts for both acute and chronic peripheral nerve injuries.</div></div>","PeriodicalId":65600,"journal":{"name":"Chinese Journal of Plastic and Reconstructive Surgery","volume":"7 3","pages":"Pages 145-148"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent advances in scalable exosome production: Challenges and innovations","authors":"Hanfei Chen,&nbsp;Qingfeng Li","doi":"10.1016/j.cjprs.2025.05.001","DOIUrl":"10.1016/j.cjprs.2025.05.001","url":null,"abstract":"<div><div>Exosomes, nanosized extracellular vesicles (30–150 ​nm), play a crucial role in intercellular communication and are promising biomarkers and therapeutic agents in oncology, neurodegenerative disorders, and immunotherapy. However, their widespread clinical adoption is constrained by challenges in scalable production, efficient purification, and regulatory standardization. This review critically evaluates recent advancements in exosome bioprocessing, including cell source optimization, culture refinement, and next-generation isolation technologies such as microfluidic microarrays and EXODUS systems. Additionally, we address the limitations of current exosome standardization efforts and propose harmonized protocols to enhance reproducibility. Future research should focus on integrating scalable bioreactor-based systems and artificial intelligence-driven quality control frameworks to accelerate exosome applications in precision medicine and regenerative therapy.</div></div>","PeriodicalId":65600,"journal":{"name":"Chinese Journal of Plastic and Reconstructive Surgery","volume":"7 3","pages":"Pages 149-163"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bibliometric analysis of three-dimensional printing in craniofacial and craniomaxillofacial applications: Research trends, key contributors, and collaboration networks","authors":"Siddig Ibrahim Abdelwahab ,&nbsp;Abdullah Farasani ,&nbsp;Zenat A. Khired ,&nbsp;Ahmad Assiri ,&nbsp;Abdelkhalig Hussein Elhilu ,&nbsp;Waseem Hassan","doi":"10.1016/j.cjprs.2025.06.004","DOIUrl":"10.1016/j.cjprs.2025.06.004","url":null,"abstract":"<div><h3>Background</h3><div>Three-dimensional (3D) printing has revolutionized craniofacial and craniomaxillofacial applications, leading to substantial advancements in patient-specific treatments. In this study, a bibliometric analysis was performed to identify the key contributors, research trends, thematic developments, and collaboration networks in this evolving field.</div></div><div><h3>Methods</h3><div>Two search strategies were employed to ensure a comprehensive analysis: (1) a broad search, in which selected keywords were searched in the title, abstract, and keyword fields to capture all relevant publications, and (2) a title-specific search, in which keywords were restricted to the title field to identify publications with a strong focus on 3D printing in craniofacial and craniomaxillofacial applications. The retrieved dataset was analyzed using VOSviewer and RStudio (bibliometrix package).</div></div><div><h3>Results</h3><div>The broad search retrieved 3 534 publications, whereas the title-specific search yielded 280 publications. The analysis of these 280 papers focused on identifying the top authors, universities, and countries, as well as their research dynamics and collaboration networks. A more detailed approach was adopted by examining the titles of these 280 papers. VOSviewer segmented the titles into approximately 800 words, which were then categorized into 18 distinct thematic groups to represent research trends. The focus areas of the ten most cited papers were also analyzed.</div></div><div><h3>Conclusion</h3><div>This bibliometric study provides valuable insights into the progress in 3D printing for craniofacial and craniomaxillofacial applications. By highlighting the key contributors, thematic developments, and collaborative networks, this study offers a foundation for future research in this rapidly advancing field.</div></div>","PeriodicalId":65600,"journal":{"name":"Chinese Journal of Plastic and Reconstructive Surgery","volume":"7 3","pages":"Pages 179-190"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention of postoperative complications in axillary lymphadenectomy through adhesive application","authors":"Igor Vladimirovich Reshetov,&nbsp;Viktoriia Vitalievna Nebezheva,&nbsp;Natalya Sergeevna Sukortseva,&nbsp;Alim Arsenovich Nebezhev","doi":"10.1016/j.cjprs.2025.08.004","DOIUrl":"10.1016/j.cjprs.2025.08.004","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative complications, particularly those involving lymphatic drainage, remain a significant challenge for patients undergoing axillary lymphadenectomy (ALND) as part of breast cancer surgery. These complications can delay the initiation of adjuvant therapies, increase healthcare costs, and negatively affect patients’ quality of life. This study evaluated the use of a latex-based tissue adhesive (LTA) as an intraoperative strategy to prevent seroma formation and prolonged lymphorrhea following axillary dissection.</div></div><div><h3>Methods</h3><div>In this prospective study, 65 female patients diagnosed with stage IIb–III breast cancer and clinically confirmed axillary lymph node involvement were enrolled. Participants were divided into two groups. The study group (<em>n</em>=33) received an intraoperative application of LTA without drainage, while the control group (<em>n</em>=32) underwent standard ALND with placement of a silicone vacuum drain. Postoperative outcomes assessed included lymphatic drainage volume, number of aspirations, duration of lymphorrhea, length of hospital stay, and incidence of complications.</div></div><div><h3>Results</h3><div>Use of the LTA significantly reduced both the volume and duration of postoperative lymphorrhea. By postoperative day 10, the average wound exudate volume in the LTA group was 8.2 ​± ​3.3 ​mL, compared to 54.1 ± 3.9 ​mL in the control group—an 84.8% reduction. The LTA group also experienced shorter hospital stays and fewer cases of postoperative seroma requiring intervention.</div></div><div><h3>Conclusion</h3><div>LTA appears to be a safe, effective, and practical intraoperative technique for preventing lymphatic complications after ALND. Its use may reduce dependence on drainage systems, shorten hospitalization, and support earlier initiation of adjuvant therapies, ultimately improving surgical outcomes and patient recovery.</div></div>","PeriodicalId":65600,"journal":{"name":"Chinese Journal of Plastic and Reconstructive Surgery","volume":"7 3","pages":"Pages 123-126"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Botulinum toxin in orofacial muscle hypertonicity: Clinical insights and therapeutic applications","authors":"Rudhra Kannan,&nbsp;Ranjith Mari,&nbsp;Anitha Balaji,&nbsp;Preethi Padmanaban","doi":"10.1016/j.cjprs.2025.08.001","DOIUrl":"10.1016/j.cjprs.2025.08.001","url":null,"abstract":"<div><div>Orofacial muscle hypertonicity, characterized by excessive muscle tension in the facial and masticatory regions, can lead to significant functional impairment and aesthetic concerns. Botulinum toxin type A (BoNT-A), widely known for its cosmetic applications, has emerged as a valuable therapeutic tool in dentistry and maxillofacial medicine. This review explores the pharmacological mechanisms, anatomical considerations, and clinical applications of BoNT-A in the treatment of functional disorders such as bruxism, masseter hypertrophy, temporomandibular joint dysfunction, and facial asymmetry. Emphasis is placed on precision-guided injection techniques, region-specific dosing trends, and formulation-specific performance. Adverse effects, although generally mild and self-limiting, are preventable through anatomical expertise and individualized protocols. Preliminary clinical observations and recent East Asian data suggest variations in the response patterns and optimal dosing strategies. This review also highlights the current gaps, including the need for long-term safety data, standardized training for dental practitioners, and comparative evaluations with non-pharmacological therapies. BoNT-A is a minimally invasive interdisciplinary approach for restoring oral function and facial harmony, supporting its integration into modern dental practice.</div></div>","PeriodicalId":65600,"journal":{"name":"Chinese Journal of Plastic and Reconstructive Surgery","volume":"7 3","pages":"Pages 164-172"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment efficacy of sclerotherapy by polidocanol vs. bleomycin for pyogenic granuloma in children: A comparative study","authors":"Shengmiao Li ,&nbsp;Xiaoying Wu ,&nbsp;Chunfen Luo ,&nbsp;Linjun Yu","doi":"10.1016/j.cjprs.2025.07.002","DOIUrl":"10.1016/j.cjprs.2025.07.002","url":null,"abstract":"<div><h3>Background</h3><div>Pyogenic granuloma (PG) is a benign vascular skin lesion that occurs in children. Although, sclerotherapy is a common treatment for patients with PG, all the previous studies have been case reports or series. At present, no reports have compared the efficacy of the two different sclerosing agents, polidocanol and bleomycin, in the treatment of PG. Therefore, we aimed to compare the cure rates and adverse reactions associated with these two agents in sclerotherapy for PG in children.</div></div><div><h3>Methods</h3><div>This retrospective analysis included children &lt;18 years of age with PG undergoing cutaneous treatment at our hospital between January 2016 and January 2022. Two sclerosing agents, polidocanol and bleomycin, were topically injected. The efficacy and incidence of adverse reactions were compared between the two groups.</div></div><div><h3>Results</h3><div>A total of 117 children with PG were divided into the polidocanol (<em>n</em>=52) and bleomycin (<em>n</em>=65) groups. Lesions disappeared after one injection in 38 children, two in 11 children, and three in 3 children in the polidocanol group. A similar phenomenon was observed after one injection in 53 children, two injections in 8 children, and three injections in children in the bleomycin group. The single-injection cure rate was not significantly different between the two groups (<em>P</em>&gt;0.05). The rate of adverse reactions was significantly different between the two groups (<em>P</em>&lt;0.05). No severe complications occurred, and no recurrences were detected during the 6–12 months of postoperative follow-up period.</div></div><div><h3>Conclusion</h3><div>This study showed that both polidocanol and bleomycin are safe and effective sclerosing agents for treatment of PG in children. The incidence of adverse reactions to polidocanol was lower than that to bleomycin. We recommend sclerotherapy with polidocanol as a first-line treatment for PG, as it is suitable for application in hospitals at various levels.</div></div>","PeriodicalId":65600,"journal":{"name":"Chinese Journal of Plastic and Reconstructive Surgery","volume":"7 3","pages":"Pages 127-132"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poland syndrome complicated by macromastia in an adolescent female: A case report and literature review","authors":"Huijing Wang ,&nbsp;Dawei Li ,&nbsp;Nan Li,&nbsp;Cheng Huang,&nbsp;Xueqing Hu","doi":"10.1016/j.cjprs.2025.06.001","DOIUrl":"10.1016/j.cjprs.2025.06.001","url":null,"abstract":"<div><div>Poland syndrome (PS) is a rare congenital condition characterized by unilateral absence or underdevelopment of the pectoralis major muscle, frequently accompanied by breast and chest wall anomalies. We report the case of an 18-year-old Chinese female diagnosed with PS complicated by contralateral macromastia who presented with significant breast asymmetry. Magnetic resonance imaging revealed a left breast volume of 618.90 mL and a right breast volume of 1 137.04 mL. The patient underwent a staged reconstruction that included a right breast reduction mammaplasty and three sessions of autologous fat grafting to the left breast. Postoperative imaging 3 months after the final procedure confirmed near symmetry, with volumes measuring 831.37 mL (left) and 841.07 mL (right). The clinical follow-up demonstrated stable results and no complications. This case underscores the importance of individualized surgical planning, precise volumetric assessment, and the role of fat grafting in achieving satisfactory aesthetic outcomes in patients with PS and complex breast deformities.</div></div>","PeriodicalId":65600,"journal":{"name":"Chinese Journal of Plastic and Reconstructive Surgery","volume":"7 3","pages":"Pages 140-144"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technical refinement of the reverse homodigital dorsoradial flap: A preliminary case report on flap optimization for radial thumb defects","authors":"Nhat Dang Huy Nguyen ,&nbsp;Huy Anh Pham ,&nbsp;Phu Man Truong Ho ,&nbsp;Phi Duong Nguyen","doi":"10.1016/j.cjprs.2025.08.002","DOIUrl":"10.1016/j.cjprs.2025.08.002","url":null,"abstract":"<div><div>Soft tissue reconstruction of the radial thumb tip remains surgically challenging, particularly when standard options such as kite or Brünelli flaps are less suitable due to anatomical constraints. This technical note presents the case of a 37-year-old male with a radial-sided distal thumb defect reconstructed using a reverse homodigital dorsoradial flap. Two key refinements were applied: preservation of approximately 5 ​mm of subcutaneous tissue to support venous outflow and a 3–5 ​mm proximal safety margin at the pivot point based on Doppler assessment to reduce pedicle tension during 180° rotation. The flap was inset without tunneling and healed without complications. Functional recovery was confirmed by progressive improvements in the disabilities of the arm, shoulder and hand score (from 25 ​at 1 month to 4.2 ​at 1 year), normal range of motion, and two-point discrimination (from 5 ​mm to 4 ​mm). This case highlights the practical advantages of flap design refinement for radial thumb reconstruction and supports its reproducibility in similar clinical scenarios. However, as this is a single case report, further validation with studies involving multiple cases is necessary to confirm the reliability and broad applicability of these refinements.</div></div>","PeriodicalId":65600,"journal":{"name":"Chinese Journal of Plastic and Reconstructive Surgery","volume":"7 3","pages":"Pages 191-196"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Botulinum toxin therapy for androgenetic alopecia: From mechanistic insights to clinical applications","authors":"Baoyi Li ,&nbsp;Changjiang Zhao ,&nbsp;Ruiyu Luo ,&nbsp;He Yan ,&nbsp;Zihan Li ,&nbsp;Lingling Jia ,&nbsp;Hua Jiang ,&nbsp;Yufei Li","doi":"10.1016/j.cjprs.2025.08.006","DOIUrl":"10.1016/j.cjprs.2025.08.006","url":null,"abstract":"<div><h3>Background</h3><div>Androgenetic alopecia (AGA) is a common hair loss disorder that significantly affects patient’s quality of life. Botulinum toxin (BoNT) has emerged as a potential treatment; however, its effectiveness and underlying mechanisms remain unclear. This systematic review aimed to synthesize the existing evidence on BoNT for AGA, analyze its mechanisms, evaluate its efficacy, and explore its potential for precision therapy.</div></div><div><h3>Methods</h3><div>A PubMed search was conducted for studies published between 2020 and 2025. A total of 25 studies, including 11 clinical trials and 7 reviews, were included. The studies were analyzed for BoNT mechanisms in AGA, treatment regimens, efficacy, outcomes, cost-effectiveness, and safety profiles.</div></div><div><h3>Results</h3><div>Experimental evidence suggests that BoNT reduces transforming growth factor-β in dermal papilla cells, a key pathological pathway in AGA. Other hypothetical mechanisms, such as scalp muscle relaxation improving microcirculation or inhibiting androgen conversion require further validation. In clinical trials, most studies used 30–150 U of BoNT via intramuscular (six studies) or intradermal (three studies) injections, with 1–3 sessions and up to 6 months of follow-up. Early open-label trials reported response rates of 70%–79%, but recent high-quality randomized controlled trials (RCTs) showed no significant improvement in hair density compared to placebo. Combination therapy with finasteride or minoxidil enhanced treatment outcomes, though large-scale evidence is lacking. BoNT was less cost-effective than first-line therapies such as minoxidil, with session costs approximately 37 times higher. Intramuscular injection appeared more effective than intradermal injection, possibly due to scalp muscle relaxation and vascular decompression. BoNT generally had a mild safety profile.</div></div><div><h3>Conclusion</h3><div>Currently, BoNT lacks robust evidence to replace traditional treatments for AGA. Future research should focus on establishing standardized dosing protocols, conducting large-scale, long-term RCTs, and integrating molecular biomarkers to improve understanding and optimize the clinical use of BoNT in AGA management.</div></div>","PeriodicalId":65600,"journal":{"name":"Chinese Journal of Plastic and Reconstructive Surgery","volume":"7 3","pages":"Pages 173-178"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}