Cosmetic Improvement Research Articles

Surgery for fibroadenoma arising from axillary accessory breast

BackgroundPatients with fibroadenomas in axillary accessory breasts (AABs) have a palpable mass, cyclic axillary pain, and aesthetic concerns that must be addressed. We compared the baseline patient characteristics, AAB characteristics, and surgical outcomes of patients with AABs with and without fibroadenomas undergoing surgical excision. We also monitored the patients for recurrence of axillary fibroadenomas.MethodsThis retrospective study involved 2310 women who underwent AAB excision from 2014 to 2019. Patients with and without a palpable fibroadenoma were divided into a fibroadenoma group and non-fibroadenoma group, respectively. All patients underwent complete excision of accessory mammary gland (AMG) tissue, including fibroadenomas in the AABs. We removed the fibroadenoma and the AMG tissue with a minimal axillary incision.ResultsThirty-nine patients had a palpable fibroadenoma in the AAB, and all patients in the fibroadenoma group had cyclic axillary pain and a palpable axillary mass. There were no significant differences in the patients’ age, weight of the AMG tissue, liposuction volume, or fibroadenoma laterality between the two groups. The body mass index in the fibroadenoma group was lower than that in the non-fibroadenoma group (19.9 vs. 22.3 kg/m2, respectively; P < 0.000). Concurrent fibroadenoma excision in a normal breast on the chest was performed more often in the fibroadenoma group than in the non-fibroadenoma group (35.9% (14/39) vs. 4.1% (92/2271), respectively; P < 0.000). The mean fibroadenoma size was 2.1 cm (range, 1.1–9.1 cm). All patients were satisfied with the degree of postoperative pain relief, disappearance of palpable lesions, and cosmetic improvement. No patients developed fibroadenoma recurrence.ConclusionsComplete excision of the AMG tissue and fibroadenoma is appropriate in patients with an AAB with a fibroadenoma. Surgeons should also consider the high incidence of concurrent fibroadenomas in the normal breasts on the chest.

Recurrent contracted sockets treated with personalized, three-dimensionally printed conformers and buccal grafts.

Purpose:Recurrent contracted sockets are complex situations where previous surgeries have failed, disabling the wear of an ocular prosthesis. A combined method of surgery and long-term fixation using custom-made, three-dimensional (3D) printed conformers is evaluated.Methods:Retrospective case series of nine patients with recurrent excessive socket contraction and inability to wear a prosthesis, caused by chemical burns (n = 3), fireworks (n = 3), trauma (n = 2) and enucleation and radiotherapy at childhood due to optic nerve glioma (n = 1) with three average previous socket surgeries (range 2–6). Treatment consisted of a buccal mucosal graft and personalized 3D-printed conformer designed to be fixated to the periosteum and tarsal plates for minimal 2 months. Primary outcome was the retention of an ocular prosthesis. Secondary outcome was the need for additional surgeries.Results:Outcomes were measured at final follow-up between 7 and 36 months postoperatively (mean 20 months). Eight cases were able to wear an ocular prosthesis after 2 months. Three cases initially treated for only the upper or only the lower fornix needed subsequent surgery for the opposite fornix for functional reasons. Two cases had later surgery for cosmetic improvement of upper eyelid position. Despite pre-existing lid abnormalities (scar, entropion, lash deficiency), cosmetic outcome was judged highly acceptable in six cases because of symmetric contour and volume, and reasonably acceptable in the remaining two.Conclusions:Buccal mucosal transplant fixated with a personalized 3D-designed conformer enables retention of a well-fitted ocular prosthesis in previously failed socket surgeries. Initial treatment of both upper and lower fornices is recommended to avoid subsequent surgeries for functional reasons.

Cranioplasty using Titanium Mesh Versus Acrylic Bone Cement: Short-term Outcomes and Complications

Background: Cranioplasty is a reconstructive procedure to restore bone anatomy and repair skull defects. Optimum reconstruction could be a challenge for neurosurgeons, and therefore the strategy to attain the ideal result remains a subject of discussion. Aim: we aimed at comparing two completely different prostheses in reconstructing calvarial bone defects, titanium mesh and polymethyl methacrylate (PMMA) bone cement. We looked for the differences in the cosmetic and functional outcomes as well as the prosthesis-related complications. Patients and Methods: This was a randomized prospective study on the first forty successive adult patients with calvarial skull defects of different etiologies, sites and sizes admitted and operated upon at neurosurgery department, Minia University hospital between January 2017 and December 2018. We divided patients into 2 groups, Group1: 20 patients were operated upon using Titanium mesh and Group 2: 20 patients were operated upon using (PMMA) acrylic bone cement implants. Results: Regarding cosmetic appearance, functional outcome, and improvement of the clinical symptoms (syndrome of trephined), Cranioplasty using titanium mesh and acrylic bone cement proved to have non-significant differences in the reconstruction of calvarial skull defects of different etiologies. However, there is a statistically significant difference between both materials regarding complications especially with large skull defects (≥25 cm2). Conclusion: there is no statistical difference between both materials regarding cosmetic and functional outcomes. However, large bone defects (≥25 cm2)are better treated with titanium mesh due to lower incidence of complications.

Iris reconstruction: A perspective on the modern surgical armamentarium.

The surgical reconstruction of eyes with iris defects is almost invariably complex and challenging. A number of prosthetic iris devices are available including large-incision, rigid diaphragm, aniridic intraocular lens style devices, small-incision devices incorporating a capsular ring, and flexible, customized, small-incision iris prostheses. The surgical techniques for rehabilitation are dictated by the configuration of the iris defect, the presence of concurrent ocular pathology, and the functional complaint of the patient. Successful rehabilitation requires careful surgical planning and appropriate patient selection. Nonetheless, endowed with the modern surgical armamentarium, the reconstructive surgeon may achieve significant functional and cosmetic improvement.

Decompressive Craniectomy and Cranioplasty: A Review of the Literature on Evolution, Indications, Surgical Techniques, and Complications

Decompressive craniectomy refers to removal of a portion of the skull without subsequent replacement, and cranioplasty involves subsequent repair of the skull vault defect. Over the past 3 decades, there has been considerable interest in the use of decompressive craniectomy as part of a second-level measure in the management of refractory raised intracranial pressure. Raised intracranial pressure can be secondary to various causes, including severe head injury, subarachnoid hemorrhage, infection, and acute ischemia. Although the procedure is thought to be effective, several factors should be taken into consideration, including patient selection, optimal time for intervention, risk of associated complications, and patient outcomes. After a craniectomy, patients may subsequently undergo cranioplasty for various reasons, including cosmetic improvement, protection of brain tissue, and as treatment for syndrome of the trephined. Several different materials have been trialed over the years, including biologic and nonbiologic substitutions. Perioperative imaging evaluation plays an important role in the management and follow-up of these patients. The focus of this article is on the expected radiologic appearances in the perioperative period as well as the complications that may arise. Surgical techniques, cranioplasty materials, and historic evolution of decompressive craniectomy and cranioplasty will also be discussed.Learning Objective: To understand the rationale for decompressive craniectomy and cranioplasty as well as recognize the expected postoperative radiologic appearances and their associated complications.

Asymptomatic disseminated telangiectasias: a rare case of cutaneous collagenous vasculopathy

Cutaneous collagenous vasculopathy (CCV) is a rare idiopathic microangiopathy affecting superficial dermal blood vessels. It is characterized by asymptomatic, disseminated, telangiectatic macules that typically involve the extremities. We report the case of a 58-year-old woman who presented with widespread telangiectasias of three years' duration on the upper extremities and abdomen. Cutaneous collagenous vasculopathy may be underdiagnosed as it is often mistaken for disorders that are morphologically very similar, including generalized essential telangiectasia, hereditary hemorrhagic telangiectasia, and pigmented purpuric dermatosis. The diagnosis of CCV is made histologically and findings feature dilated superficial dermal vessels with thickened walls containing periodic acid-Schiff-positive eosinophilic hyaline material. Effective treatment options for CCV have yet to be established and given its benign disease course, treatment may not be necessary. Pulsed dye laser can be offered to patients for cosmetic improvement but the extent of the disease makes complete lesion clearance challenging in most cases. Given the lesions were asymptomatic our patient declined all offered treatment modalities.

Modified Woodward's procedure confers functional improvement in Sprengel's deformity.

Modified Woodward's procedure improves shoulder movement and cosmesis. There is a paucity of literature reporting objective assessment of functional outcomes. We report cosmetic and functional outcomes in Sprengel's deformity treated with modified Woodward's procedure. Children aged 12 years and under, who underwent Modified Woodward's procedure from January 2006 to December 2014 were included in the prospective study. Improvement in Cavendish grade, Rigault scale, and shoulder movements was noted. Pediatric outcomes data collection instrument (PODCI) and simple shoulder test (SST) scores were assigned at the final follow-up. Statistical analysis was conducted with paired T-test and Wilcoxon signed-rank tests. Fourteen patients (one bilateral) with a mean follow-up of 4.5 years (1-8 years) were analyzed. The mean age at surgery was 5.7 years (3-12 years). Ten (71%) patients had omovertebral bars. Six patients had Klippel-Feil syndrome including one with cervical hemivertebrae with anterior chest wall deficiency. Cavendish grade and Rigault scale improved significantly (P < 0.05). Mean shoulder abduction and forward flexion improved by 37.3° (P < 0.001) and 38.7° (P < 0.001), respectively. The mean normative PODCI score was 24.07 (reported normative score ranges from -146 to 53) and the SST score was 9.64 (reported score ranges from 0 to 12). SST scores demonstrated a moderate correlation with shoulder function. Patients without associated anomalies had better cosmetic (P = 0.057) and functional (P = 0.029) improvement. Modified Woodward's procedure improved cosmesis and provided near-normal functional outcomes in children irrespective of age and sex. Better improvement was noted in children without anomalies.

Effects of corrective strabismus surgery on social anxiety and self-consciousness in adults

To report the results of a questionnaire-based interventional study to evaluate the effects of strabismus surgery on private self-consciousness, public self-consciousness, and social anxiety using a validated self-consciousness survey instrument. Patients who underwent strabismus surgery completed a demographics and a self-consciousness scale form both pre- and postoperatively. The total and subscale (private self-consciousness, public self-consciousness, and social anxiety) summative scores were compared using the Wilcoxon signed-rank test, with statistically significant relationships defined as P<0.05. Total and subscale summative scores were analyzed as such and by strabismus type, years of education, and marital status. Overall improvement was found postoperatively in total scores (P=0.012), public self-consciousness scores (P=0.009), and social anxiety scores (P=0.028). Although improvement was noted for the private self-consciousness subscale (P=0.188), it did not reach statistical significance. Subdivided according to strabismic and demographic subgroups, significant improvement was only noted in esotropic patients, college graduates, married/living partner/widowed patients, and separated/divorced patients. This study suggests that beyond functional and cosmetic improvements, strabismus surgery can result in improved public self-consciousness and social anxiety, with greatest effect noted in esotropic, college graduates, and nonsingle patients.

Comparison of efficacy of noncultured hair follicle cell suspension and noncultured epidermal cell suspension in repigmentation of leukotrichia and skin patch in vitiligo: a randomized trial.

Vitiligo manifests as hypo- to de-pigmented macules, which are sometimes associated with leukotrichia. For complete cosmetic improvement, the repigmentation of leukotrichia is an important component. This randomized controlled trial included patients with stable vitiligo with leukotrichia. Two vitiligo patches in each patient were randomized to receive either of the two procedures. The patients were followed up for 9months posttransplantation. The efficacy of hair follicle cell suspension (HFCS) with epidermal cell suspension (ECS) in repigmentation of leukotrichia and skin in vitiligo was compared. A total of 20 patients underwent the procedure, and 19 completed the follow-up. The area of the vitiligo patch and the number of leukotrichia in the patches were comparable between the two groups. There was a significant difference in the mean±S.D. number of cells transplanted between the two groups (5.06×105 in HFCS vs. 39.8×105 in ECS, P<0.0001). The percentage viability of cells and proportion of melanocytes were comparable between the two groups. A total of 10 patients in HFCS and eight patients in ECS had repigmentation of leukotrichia. The mean±S.D. percentages of depigmented hair showing repigmentation at nine months were 7.42±11.62% in HFCS and 11.42±17.90% in ECS (P=0.4195), whereas the mean±S.D. percentage repigmentation of vitiligo patches was 61.58±42.68% in HFCS and 78.68±30.03% in ECS (P=0.1618). The mean number of cells transplanted in the HFCS group was about eight times less than those in ECS. ECS was better than HFCS in repigmentation of leukotrichia and vitiligo, although the difference was not statistically significant.

Quickert procedure for involutional lower eyelid entropion: a multi-centre study

Background: Involutional entropion is the inward turning of the eyelid margin and commonly happens in the inferior eyelids in elderly people. The prevalence is as high as 2.1% in people ≥ 60 years old and more common in women than men. This condition may cause ocular surface irritation and discomfort secondary to contact between cilia and the ocular surface. Several etiological factors are suspected to be important causes of involutional entropion. One of them was horizontal eyelid laxity. Quickert Procedure is one of the surgical interventions recommended to correct involutional lower eyelid entropion in the elderly Asian population with 0% of recurrent entropion in a recent study by Miyamoto et al.Methods: This is a descriptive retrospective study of 16 involutional lower eyelid entropion patients (18 eyelids) that needed surgical correction.  About ten males and six females were undergone Quickert procedure to correct the involutional entropion. Patients were assessed postoperatively for 24 months to evaluate the recurrence entropion, cosmetic, and functional improvement. Data were analyzed by SPSS version 20 for Windows.Results: This study included 16 patients, with mean age was 69.8 years old which range from 62-85 years old. They consisted of 9 (56.0%) patients were male, and the rest was female (44.0%). Eleven (61.0%) patients were with left eye laterality, and 10 (63.0%) patients found without anticoagulant consumption. All patients (100.0%) had positive snapback test and achieved &gt;6 mm in distraction test. After surgical intervention, no patients (0.0%) were found to experience recurrence of involutional entropion nor ocular discomfort due to prior surgery.Conclusion: A detailed assessment of the etiology, accurate preoperative evaluation, and precision in addressing patients underlying eyelid anatomic abnormalities are needed in the selection of appropriate surgical procedures to correct entropion.

Understanding families’ experiences following a diagnosis of non-syndromic craniosynostosis: a qualitative study

ObjectivesCraniosynostosis is typically diagnosed and surgically corrected within the first year of life. The diagnosis and surgical correction of the condition can be a very stressful experience for families. Despite...

Effect of botulinum toxin type A for treating hypertrophic scars: A split-scar, double-blind randomized controlled trial.

Hypertrophic scars (HS) are a challenging disorder that mostly develops during wound-healing process following skin injuries. A split-scar, double-blind randomized controlled trial was held to assess the safety and efficacy of botulinum toxin type A (BTA) injection in hypertrophic scars (HS). Thirty patients with old scars (range: 1-15years) were treated, with sides randomized to receive treatment with either BTA or 0.9% normal saline once monthly for three consecutive months. Scars were assessed using the Vancouver scar scale (VSS) along with digital photograph standardization. Twenty-one subjects completed the study. The mean VSS score for the BTA-treated half of the scars decreased from 7.29±2.327 before injection to 5.33±2.41 following injection which was highly significant (P=.01). For the control half, the mean VSS decreased insignificantly from 7.29±2.327 before injection to 7.10±2.234 following injection (P=.104). Clinical and cosmetic improvement was demonstrated significantly among the BTA-treated group. BTA can be an additional and useful tool for improving scar outcomes.

Linear Scleroderma of the Head - Updates in management of Parry Romberg Syndrome and En coup de sabre: A rapid scoping review across subspecialties.

To provide an update on the current management, including evaluation and treatment, and the available diagnostic tools for linear scleroderma of the head, i.e., Parry-Romberg Syndrome and en coup de sabre (PRS/ECDS). A rapid scoping review of the literature was conducted to include manuscripts published in English between 2010 and 2019. Literature searches were performed in PubMed and EMBASE databases. The were analyzed for descriptive statistic reporting. This study reviewed 215 manuscripts reporting these 1430 patients. Surgical reports comprised the majority of the reviewed literature. Most PRS/ECDS did not appear to receive comprehensive multisubspecialty evaluation for extracutaneous manifestations; 21% of cases noted neurological screening, 4% noted dental screening, and 3% noted ophthalmologic screening. Methotrexate and glucocorticoids remain the most frequent choice for immunosuppressive treatment, though fewer than 7% of patients reported receiving systemic medical therapies. Surgical procedures for cosmetic or functional improvement were common (59%) among the reported patients. Autologous fat grafting was the most frequently utilized cosmetic treatment (50% of procedures) followed by free flap transfers (24% of procedures). There is ongoing need for standardized evaluation, monitoring, and treatment to prevent morbidity in PRS/ECDS, especially in children. When these patients are managed by rheumatologists, methotrexate, and steroids remain the first-line treatment, but a review of the published literature reflects that this may be a minority. Most PRS/ECDS patients are not evaluated in a multidisciplinary fashion. We propose comprehensive evaluations across subspecialties at the baseline and follow-up levels to monitor disease activity and record extracutaneous manifestations, treatment algorithms, and surgical intervention considerations.

Aesthetic outcome of intralesional injection of lauromacrogol as a single-agent treatment for uncomplicated infantile hemangiomas: A long-term follow-up study.

Infantile hemangiomas (IH) are at risk of incomplete regression with remnant permanent sequelae, ranging from passive waiting for spontaneous regression to active systemic administration. The application of traditional therapy involving injection of a sclerosing agent is limited due to the difficulty in achieving cosmetic improvement. This study aimed to explore a new injection method that could not only promote tumor regression but also achieve cosmetic improvement. A total of 122 IH (from 109 children) injected intralesionally with lauromacrogol in the Plastic Surgery Department of Fujian Medical University Union Hospital between 1January 2012 and 1June 2019 were enrolled in this study. The mean follow-up time was 2.9years. Of 122 lesions studied, 111 (91.0%) achieved complete regression, 10 (8.2%) achieved significant regression and one (0.8%) achieved moderate regression. In terms of aesthetic appearance, 70 (57.4%) IH had no sequelae and the A score was 5/5. Twenty-one (17.2%) IH had minimal hyperpigmentation, hypopigmentation or telangiectasia and the A score was 4/5. Thirty-one (25.4%) IH had left mild or relatively obvious sequelae and the A score was 1-3/5. None of the 122 IH involved had rebound growth after terminating the treatment. Hyper- or hypopigmentation gradually faded over time and part of the IH had already returned to normal appearance by the time of long-term follow up. The results indicated that this new type of injection therapy significantly promoted the regression of uncomplicated IH and helped achieve the expected cosmetic appearance.

Ectrodactyly or lobster claw feet: our surgical experience

Introduction: Ectrodactyly, often the center of attraction due to the mystifying appearance, is a challenging surgical entity as more often the affected children seek cosmetic improvement and also want their feet to fit into normal footwear. Aims and objectives: Not much has been written in the literature of the surgical treatment of this rare entity. This article has been written to address the surgical options and treatment of this rare deformity. Results: We report a case series of five affected children treated in our institute over a period of 4 years. The cases were followed up for a period of 1 year, and there were no recurrence. Conclusion: Surgical descriptions for correction of this rare entity are few and this article aims to address this lacuna, helping in proper correction of this deformity.

The efficacy and safety of microwave ablation versus lobectomy for the treatment of benign thyroid nodules greater than 4 cm.

To evaluate the safety and effectiveness of microwave ablation (MWA) versus lobectomy for the treatment of benign thyroid nodules > 4 cm. We retrospectively analyzed the data of 48 patients who underwent MWA and 53 patients who underwent lobectomy to treat benign thyroid nodules > 4 cm. The patients were followed up for 12 months. The volume reduction ratio (VRR) was calculated. The operation time, incision length, hospitalization time, complications, thyroid function, symptoms, and cosmetic improvement were analyzed and compared between the two groups. During the 12-month follow-up, the mean nodule volume in the MWA group was reduced from 36.1 ± 23.1 to 4.0 ± 4.1 ml, and the mean VRR of the nodules was 90 ± 5% in the MWA group, which was comparable with that in the surgery group. No significant postoperative change in thyroid function was observed in the MWA group. Compared with the surgery group, the incidence of complications and postoperative pain in the MWA group were lower, the operation time, incision length, and hospitalization time in the MWA group were shorter, and satisfaction with the esthetic results in the MWA group was greater. MWA is safe and effective for the treatment of benign thyroid nodules > 4 cm. Moreover, MWA is associated with a faster recovery, fewer complications, better protection of thyroid function, and superior esthetic results relative to thyroid lobectomy.

MON-505 Quantitative Characteristics and Sonographic Patterns Before and After Thyroid Radiofrequency Ablation

Although most thyroid nodules (TNs) are benign and require only serial observation, some may need treatment for symptoms. Radiofrequency ablation (RFA) has been used and shown to be a promising and well-tolerated new approach. The efficacy of RFA is evaluated by using parameters such as volume reduction ratio (VRR), and cosmetic or symptomatic improvement. However, no index is now available to predict the therapeutic success before RFA. And apart from size reduction, little is known about their ultrasonography (US) appearances after RFA. The purpose of this study was to 1) assess the effectiveness of single session RFA treatment on volume reduction 2) determine if quantitative US characteristics are correlated to the VRR 3) demonstrate the US characteristics from the baseline and during the follow-up. Quantification of characteristics was performed using commercial software. The CAD software classified nodules into the 2015 ATA sonographic patterns and TIRADS categories. All patients underwent a single treatment session and with significant improvement in cosmetic and pressure symptoms. It shows that there is a direct correlation between the initial tumor size/cyst component percentage and VRR. The US characteristics are significant different after RFA, and the tumors were categorized to more suspicious ATA patterns and had higher TIRAD scores. In conclusion, RFA is effective on volume reduction and US characteristics correlated with therapeutic success. Post RFA US features may potentially mislead and clinicians should always keep in mind.

Graded transantral orbital decompression outcomes in stable thyroid eye disease: a series of 47 orbits

ABSTRACT Purpose: To provide outcome data for transantral orbital decompression for functional and aesthetic rehabilitation for exophthalmos in stable thyroid eye disease (TED). Methods: Retrospective, non-comparative chart review of consecutive TED patients who underwent primary-graded transantral orbital decompression for exophthalmos by a single surgeon (MAB) between 2005 and 2018. Additional inclusion criteria included follow-up >90 days and no prior orbital surgery. Outcome data collection included millimeters of proptosis reduction, postoperative complications, and patient satisfaction. Results: A total 30 patients (47 orbits) were included. Average reduction in proptosis: 2.8 mm (range 0–9 mm, median 2.5 mm). Post-operatively, new onset diplopia occurred in four patients, V2 numbness in 15 patients (17 orbits), and sinusitis in 2 patients (2 orbits). Phone surveys reached 9/30 patients (14 orbits): cosmetic improvement was reported in 14/14 orbits, relief of orbital ache reported in 10/10 orbits with pre-operative ache, relief of dry eye in 8/13 orbits with preoperative dry eye, and overall satisfaction score: 8.9/10 (range 4–10, median 10). Conclusions: Graded transantral orbital decompression is a viable option for stable TED patients with orbital ache, exophthalmos, and exposure keratopathy, resulting in a high degree of functional and cosmetic satisfaction in our cohort.

Surgical correction of Sprengel's deformity by modified Woodward procedure: outcomes in twenty eight patients.

Sprengel's deformity is a congenital failure of the descent of the scapula with main concerns regarding cosmetic deformity and restricted function of the affected shoulder. The purpose of this study was to present the results of Modified Woodward procedure in 28 patients with Sprengel's shoulder. Twenty-eight patients (9 males, 19 females) of Sprengel's shoulder treated with modified Woodward procedure from 2010 to 2016 were retrospectively studied. Clinical assessment was done using Cavendish grading and Rigault's classification for radiographic evaluation. Mean age at the time of surgery was six years and three months. Mean follow-up was 20months. We found a mean increase in abduction of 34.2° (15-50) and flexion of 20.6° (10-25), mean scapular lowering of 2.3cm (0.5-4.5cm), and a Cavendish grade I in 18 (65%), grade II in 10 (35%). Thus, we had 65% satisfactory results in terms of cosmesis and 85% with the function of the affected limb. Rigault grading improved by one grade in 16 children and by two grades in 12 children. Subjectively, all parents were satisfied with the cosmetic appearance of the achieved scapular lowering. We had one case of delayed superficial wound healing which resolved spontaneously. Modified Woodward procedure for Sprengel's shoulder deformity gives good cosmetic correction and improvement in shoulder function with minimal complications. This procedure is good for selective cases of Cavendish grade II with cosmetic concerns and all cases of Cavendish grade III and IV.

Retrospective study of the treatment of port-wine stains with 595-nm pulsed dye laser in 261 Chinese patients.

Pulsed dye laser (PDL) at the wavelength of 595nm is the common choice for the treatment of port-wine stains (PWSs). In this study, the efficacy of 595-nm PDL in treatment of PWSs in Chinese patients was investigated. A follow-up visit was performed on 261 Fitzpatrick skin type II-III Chinese patients with PWS who received more than two treatments with 595-nm PDL. Based on cosmetic improvement, treatment response was graded as follows: complete, if color blanching was > 90%; significant, if color blanching was 60-90%; moderate, if color blanching was 30-60%; and poor, if color blanching was < 30%. The efficacy of laser treatment on patients of different treatment numbers, ages, lesion locations, lesion colors, extents of hypertrophy, and laser pulse durations was evaluated. All patients improved following an average of almost 4 to 5 laser treatments. The earlier the intervention, the better the efficacy was. Lesions on cheek, neck, and forehead were better than that those on oral, eye periorbital, and nose areas. The purple group had a more excellent clearance, i.e., complete and significant clearance rate (53.6%), than the red group (36.1%). Treatment effect became worse as the extent of lesion hypertrophy increased. PWS lesions treated with short pulse durations of 0.45, 1.5, and 3ms had better clearance (complete and significant clearance) rate of 56.5% than those treated with pulse durations of 6ms or longer (34.8%). Pulsed dye laser with 595-nm laser equipped with dynamic cooling device is an effective option for the treatment of PWS in Chinese patients. Younger patients with lateral face position, larger vessel size (deeper color), and lesser hypertrophy received better clinical effect than the others. Treatment with short pulse duration of less than 3ms for 4 to 5 times was recommended to treat PWS.