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Background: The increasing popularity of cosmetic injections using various fillers and neuromodulators for facial rejuvenation has brought both new opportunities and challenges to this field. Aim: Our study was designed to employ bibliometric and visual analysis for a qualitative and quantitative evaluation of facial cosmetic injections, as well as to identify research trends and hotspots in this field. Methods: All publications covering facial cosmetic injection during 2002–2023 were retrieved and extracted from the Web of Science database. The VOSviewer 1.6.18 software and the online tool (http://bibliometric.com/) were applied to analyze the publication trend. Results: A total of 3797 articles related to facial cosmetic injection were identified during the period 2002–2023. The United States had the largest volume of publications (1520, 40.0%), followed by China (333, 8.8%) and Germany (282, 7.3%). Among the institutions and journals, the University of California system and Plastic and Reconstructive Surgery accounted for the most papers related to facial cosmetic injection, respectively. Facial anatomy and injection techniques, prevention and management of complications, regenerative medicine, efficacy and safety of various soft‐tissue fillers, as well as botulinum toxin injections for facial rejuvenation were identified as hotspots for facial cosmetic injections. Conclusions: Facial cosmetic injections are showing an increasing trend in terms of both the number of published papers and operations performed. Despite the notable advancements in this field, numerous challenges persist, including safety concerns and the level of research evidence. With the emergence of novel technologies and materials, scholars from diverse countries and institutions should engage in more extensive collaboration, thereby directly expediting the progress of this field. [ABSTRACT FROM AUTHOR]

Introduction: Laser technology has fundamentally transformed the landscape of dermatology, offering nuanced solutions for skin rejuvenation and resurfacing. This paper aims to explore the spectrum of laser technologies, from ablative to non‐ablative and fractional lasers, their mechanisms, benefits, and tailored applications for diverse skin conditions. As we delve into the intricacies of each technology, we also consider the scientific advancements that have made these treatments safer and more effective, promising a new horizon in skin rejuvenation. Objective: This comprehensive analysis seeks to evaluate recent advancements in laser technology for skin rejuvenation, focusing on efficacy, safety, and patient satisfaction. Methods: The selection criteria for studies in this publication focused on recent, peer‐reviewed articles from the last 20 years, emphasizing advancements in laser technologies for skin rejuvenation. Our comprehensive review involved searches in PubMed, Cochrane, Scopus and Google Scholar using keywords like "skin rejuvenation," "laser technology," "efficacy," "safety," and "dermatology." This approach focused on inclusion of recent research and perspectives on the efficacy and safety of laser treatments in the field of dermatology. Results: Our literature review reveals advancements in laser skin resurfacing technologies, notably fractional lasers for minimal downtime rejuvenation, ablative lasers for precise tissue vaporization, and non‐ablative lasers for coagulation effect promoting collagen with reduced recovery. Hybrid and picosecond lasers are highlighted for their versatility and effectiveness in addressing a wide array of skin concerns. The findings also emphasize the development of safer treatment protocols for ethnic skin, significantly reducing risks like hyperpigmentation and scarring, thus broadening the scope of effective dermatological solutions. Conclusion: This extensive review of advancements in laser technologies for skin rejuvenation underscores a remarkable evolution in dermatological treatments, offering an expansive overview of the efficacy, safety, and patient satisfaction associated with these interventions. Furthermore, the exploration of combination treatments and laser‐assisted drug delivery represents a frontier in dermatological practice, offering synergistic effects that could amplify the therapeutic benefits of laser treatments. [ABSTRACT FROM AUTHOR]

Background: Botulinum toxin has been widely and mainly used for the treatment of conditions affecting the upper and middle face; however, recent efforts have expanded the indications of botulinum toxin injection to the lower face and neck areas for cosmetic and medical purposes. Aims: We have reviewed the latest updates on using botulinum toxin in the lower face and neck focusing on cosmetic purposes and have discussed the existing concerns as well as the adverse sequelae of these newer indications. Patients/Methods: A comprehensive literature search was performed using the following keywords [[botulinum] AND [[Toxin] OR [Neurotoxin]]] AND [[Lower AND Face] AND/OR [Neck]] within the main databases including Web of Science, PubMed, Embase and gray literature on and before February 2023. The data were screened using titles and abstracts and those relevant to the topic were included in the paper. Results: Botulinum toxin injection has considerable cosmetic and therapeutic effect on facial contouring, masseteric hypertrophy, lower face and neck scars, gummy smile, drooping lip corner and even skin rejuvenation. Conclusion: BNT injection has been widely used for the treatment of different medical and cosmetic purposes. Low rates of side effects, which were self‐limited in most cases, have been reported in the literature, making BNT a safe therapeutic medication in most cases. However, regulatory status needs to be updated and more accurately revised in many countries and more comprehensive research is required to address the existing gaps in this area including the site, dosage, and method of injection in each case. [ABSTRACT FROM AUTHOR]

Objective: Facial aging is a complex process that involves genetic, biological, and environmental factors. This paper aimed to present the first aesthetic and safety outcomes of a hybrid filler that combines hyaluronic acid (HA) (20 mg/mL) and calcium hydroxyapatite (HA/CaHa). Methods: Prospective and non‐randomized interventional study conducted on consecutive healthy patients who attended the clinic for an aesthetic facial rejuvenation procedure. HA/CaHa was injected with 23G cannula (retrograde threads, 1.25 mL per side) in the preauricular region. Ultrasound examinations, elastography images, and 2D and 3D photographs were performed before and after treatment. The primary endpoint were the volumetric changes at Day 180. Results: Fifteen patients were included in the study. At Day 180 after treatment, median (interquartile‐range) volume increased by 2.1 (1.9–2.3) cc and 2.1 (1.8–2.2) cc in the right‐ and left‐side, respectively, p < 0.0001 each. As compared to pretreatment values, facial‐tension vectors significantly increased by 2.2 (1.6–2.2) mm and 2.0 (1.7–2.2) mm in the right and left side, respectively, p < 0.0001 each. Elastography images demonstrated an increase in collagen fibers at post‐treatment Day 60, which was confirmed on Day 90, and reached the peak effect between Days 90 and 180. Regarding safety, there were no either unexpected or serious treatment‐related adverse events. Most patients experienced a mild redness and inflammation that resolved within the first 48 h without treatment. Conclusions: The HA/CaHa hybrid filler (HArmonyCa™), besides its volumizing and lifting properties, was associated with an increase in the viscoelasticity, both at the level of the reticular dermis and the subcutaneous cellular tissue, which might be indicative of the formation of new collagen fibers. [ABSTRACT FROM AUTHOR]

Background: The search for ever more lasting and safe aesthetic modalities is a constant. For this reason, biostimulation is finding more and more space in clinics; relatively simple, effective, and safe procedures, a procedure that delivers what it promises. Biostimulation is nothing more than an increase in collagen production, primarily type I, with the aim of facial or body rejuvenation. Aims: Evaluated some years ago as remarkable antimicrobial therapy, today it gains notoriety for its versatility in other areas, one of which is biostimulation, which has been growing. This paper aims to report a case of biostimulation through ozone therapy, as well as the protocol used, its indications, and contraindications. Patients/Methods: A case report of rejuvenation with ozone therapy and a literature review. Results: Among biostimulatory treatments available, one has been gaining space among professionals and scientific recognition, ozone therapy. Conclusion: It is a promising aesthetic therapeutic modality with efficient and safe results and high patient compliance and satisfaction. [ABSTRACT FROM AUTHOR]

Keywords: cosmetic procedure; facial rejuvenation; hyaluronic acid; poly-L-lactic acid; skin aging EN cosmetic procedure facial rejuvenation hyaluronic acid poly-L-lactic acid skin aging 5261 5263 3 11/02/22 20221001 NES 221001 ACKNOWLEDGEMENT The authors thank Danielle Shitara, MD PhD, for editorial assistance. CONFLICT OF INTEREST Dr Sarubi and Dr Avelar have been the speakers and consultants for Galderma Brazil. Dr Kamamoto, Dr Sarubi, Dr Avelar, Dr Del Nero and Dr Morais performed paper concept and design and critical revision of the manuscript for important intellectual content, administrative, technical, or material support, study supervision, and decision to submit the report for publication. [Extracted from the article]

Background: Non‐energy based devices used in aesthetic medicine include treatments such as microdermabrasion, microneedling, threads, and chemical peels. Practitioners may use these devices to address signs of facial photo‐ and chronological aging (fine lines, wrinkles, pigmentary, and skin textural changes). Currently, consensus papers or guidelines are lacking in peri‐procedural measures or their potential role in the prevention or treatment of adverse events in non‐energy based aesthetic procedures. Aims: To explore current practices using non‐energy devices, a survey was developed to identify trends in peri‐procedure treatment measures. Patients/Methods: The survey was sent electronically to 2000 dermatologists and 388 plastic surgeons. Randomly selected sites included those practicing medical aesthetics using non‐energy devices for facial rejuvenation. The survey gathered information related to practitioner demographics, types of devices used, and peri‐procedural measures for non‐energy device‐based treatments. Results: The survey was active from February to May 2019. Nine hundred and twenty clinicians opened the survey, and 109 surveys were completed, providing a total response rate of 11.8%. The results revealed inconsistencies with regards to skin preparation strategies and post‐procedure care. While the majority of clinicians indicated a need for topical treatments to reduce inflammation, prevent scarring, and shorten time to healing, a standard of care was not observed. Conclusions: The results of this survey confirm a lack of standardized measures for peri‐procedural care when using non‐energy based devices for aesthetic medicine treatments. These findings emphasize the need for evidence‐based recommendations for optimizing patient outcomes, reducing and managing adverse events, and shortening time to healing. [ABSTRACT FROM AUTHOR]

Background: Laser and energy‐based devices may be used for many cutaneous indications, including facial resurfacing, improving skin conditions, and reducing signs of photoaging. Currently, no consensus papers or guidelines exist concerning peri‐operative agents and specifically their use for laser skin resurfacing and their potential/possible role in prevention or treatment of side effects. Aim: To explore current practice using laser and energy devices, a survey was developed to identify the trends in pre‐ and postprocedural treatment measures. Methods: The survey was sent out digitally to 300 randomly selected US dermatologist and plastic surgeon physicians practicing medical esthetics using laser and other energy devices treatment for facial rejuvenation. The survey gathered information on demographics, types of devices used in the clinic and pre‐/postprocedural measures for facial laser, and other energy‐based devices treatment. Results: The survey was active from June 15, to July 15, 2018, and fifty‐eight dermatologists and plastic surgeons completed the survey (19.3% response rate, 58/300). The results showed inconsistency in skin preparation strategies and postprocedure wound care. The majority of survey participants (55/58 [96%]) reported prophylactic oral antiviral use pre‐ and post‐treatment; however, there was inconsistency about when to start and when to stop the use. A similar inconsistency existed in the recommended period of post‐treatment sun protection before and after treatment. Conclusion: The results of the survey confirmed the lack of consistency in the types and duration of pre‐ and postprocedural measures—emphasizing the need for evidence‐based recommendations to optimize outcomes, prevent infection, enhance comfort, and reduce downtime. [ABSTRACT FROM AUTHOR]

Introduction: The use of hyaluronic acid (HA) as a dermal filler is considered safe. However, as new brands come to the market, reports of adverse events are becoming more and more common. Objective: To describe a particular type of adverse effect that, unlike the erythematous, indurated, and painful nodules described in the literature as "angry red bumps," is characterized by noninflammatory, stony‐like nodules that appear in sites previously treated with HA. Methods: The report of four patients who presented this complication, and the occurrence of two HA syringes from the same batch that had hardened the product inside at the time of filling. Conclusion: The authors propose the nomenclature "happy bump" to group adverse reactions to HA that translate into noninflammatory nodules, with a stony consistency, appearing up to 4 weeks (recent) or after one month (late) in sites previously treated with AH. [ABSTRACT FROM AUTHOR]

Background: Lip volumization and perioral rejuvenation with hyaluronic‐acid (HA) based dermal fillers are generating increasing interest and demand. However, this topic is still having many unmet needs nowadays. This document aimed to provide tips and recommendations that may help clinicians to achieve optimal and more predictable aesthetic outcomes. Methods: A multidisciplinary group of aesthetic medicine doctors from Spain and Portugal reviewed the tools used for assessing the patient and aesthetic outcomes, as well as the different techniques and products used in lips/perioral rejuvenation. Results: The consensus panel provided specific recommendations focusing on the basic information to collect before performing the aesthetic procedure; comprehensive approach to lips/perioral region rejuvenation; clinical and aesthetic assessment tools; product and technique selection; patient profile and needs; and safety issues (complications/adverse‐events). Conclusions: The rapid evolution of techniques and tools for assessing the patient and aesthetic outcomes, as well as the development of new HA‐based fillers makes it necessary to update the clinical recommendations that guide the daily practice of clinicians, particularly those who have less experience with these procedures. This document addressed relevant subjects related to lip/perioral‐region rejuvenation to perform the correct procedure, with the appropriate HA‐based, on the right patient; to help specialists to obtain optimal and predictable aesthetic outcomes. [ABSTRACT FROM AUTHOR]

Background: Skin aging can be observed at various levels in the epidermis, dermis, and dermo‐epidermal junction. Reducing the cosmetic effects of skin aging in the facial region is a widespread demand due to common aesthetic concerns. Consequently, many injectable products on the market promise antiaging effects and cosmetic improvements. We aimed to evaluate the cosmetic efficacy of a high molecular weight sodium hyaluronate and amino acids mixture for the facial region using morphometric analysis. Methods: This study evaluates the morphometric effectiveness of an injectable mixture (high molecular weight sodium hyaluronate, glycine, L‐Proline, L‐leucine, L‐lysine HCL, L‐valine, and L‐alanine collagen active ingredient) on the mid‐face and jawline in women aged 30–55. We used morphological measurements and digital image data to assess changes and determine effectiveness. Various computational methods were applied simultaneously with statistical tests for validation. Results: The hydration assessment showed a significant increase on both sides of the face. A noticeable decrease was observed in gonion angle, bitragion breadth, bigonion breadth, and marionette wrinkle scale. These results suggest combining mechanical and chemical stimulation from the injection and its components (hyaluronic and amino acids) effectively enhances skin quality. Conclusions: The study indicates that the mechanical stimulation of the injection improves skin quality. Combining hyaluronic and amino acids (collagen, elastin, and pro‐synthetic) is a safe and effective alternative for antiaging treatments. [ABSTRACT FROM AUTHOR]

Background: Hyperbaric oxygen therapy (HBOT) involves patients breathing 100% oxygen in a pressurized chamber, above 1 atmosphere. Many centers are now promoting the use of HBOT for skin rejuvenation. However, the current indications for HBOT do not encompass aesthetic applications. Aim: The aim of this evidence‐based review was to assess the existing literature regarding the utilization of HBOT in medical aesthetics and rejuvenation, evaluate its effectiveness and safety, and conduct a cost analysis. Materials and Methods: PubMed Interface, Cochrane Library, Google Scholar, and Embase searches were carried out. The Best Bets methodology was used, and the risk of bias was appraised using the Quality Assessment Tool for Quantitative Studies. Results and Main Findings: This review included a total of 17 human studies with a total of 766 participants. Three studies were classified as level II evidence, three studies were of level III evidence, and 11 were of level IV evidence. All the included studies were judged at high risk of bias. The most relevant findings supported by level II evidence were that HBOT decreased the shedding rate post‐FUE hair transplant (27.6 ± 2.6% vs. 69.1 ± 2.4%) but this did not affect the final outcome between HBOT (96.9 ± 0.5%) and the control (93.8 ± 0.6%). Moreover, level III evidence demonstrated that following HBOT, there was a significant increase in elastic fiber length (p ≤ 0.0001, effect size = 2.71) and a significant decrease in fiber fragmentation (p = 0.012). There was also a significant increase in collagen fiber density following HBOT (p = 0.0001, effect size = 1.10). However, there was no significant effect of antioxidant vitamins A, C, and E with HBOT. The inflammatory response significantly decreased after 7 days of HBOT with a decreased expression of IL‐12p40, MIP‐1β, and PDGF‐BB and a higher expression of IL‐1Ra. Moreover, HBOT was used prophylactically prior to abdominoplasty to decrease the risk of complications. In this study, complications were decreased from 32.6% (89 patients) to 8.4% (7 patients) with a p < 0.001, and in a multivariate analysis, preoperative HBOT was an independent protective factor against postoperative complications (p < 0.001). Conclusion and Recommendations: There is conflicting evidence on how the method of action of HBOT can have a beneficiary effect in aesthetic and whether the treatment is justifiable. To our knowledge, this is the first comprehensive review discussing the available evidence regarding the use of HBOT in many aesthetic clinical scenarios, including preventive, medical, and surgical settings. However, randomized clinical trials with longer follow‐up and better patient selection are needed to be able to generate a reliable conclusion. [ABSTRACT FROM AUTHOR]

Hidradenitis suppurativa, hypothesis, fractionated microneedle radiofrequency Keywords: fractionated microneedle radiofrequency; hidradenitis suppurativa; hypothesis EN fractionated microneedle radiofrequency hidradenitis suppurativa hypothesis 410 411 2 12/29/21 20220101 NES 220101 CONFLICT OF INTEREST The authors declare that there is no conflict of interest regarding the publication of this paper. [Extracted from the article]

Background: Skin aging is characterized by wrinkles, rough skin texture, pigmentation, facial erythema, and telangiectasia through structural and functional changes in the epidermis and dermis. Recently, injectable poly(D, L‐lactic acid), a biodegradable polymer, has been used widely for skin rejuvenation. Aims: This study aims to assess the efficacy and safety of injectable dermal poly D, L‐lactic acid) for skin rejuvenation. Patients/Methods: A total of 16 patients who desired skin rejuvenation were included. All participants received two or three procedure sessions with a 4 weeks interval between sessions. Clinical and three‐dimensional images at baseline, before each procedural session, and follow‐up visits were obtained. Therapeutic effects were assessed by evaluating signs of aging skin and overall improvement by dermatologists and patients. Histologic examinations with special stains were performed on the posterior auricular areas of consenting patients at baseline and follow‐up visits after injecting poly D L‐lactic acid into the postauricular area as in the face. Results: Overall, statistically significant differences were observed in all signs of aging skin, such as fine wrinkles, skin texture, irregular pigmentation, telangiectasia, and facial erythema before and after treatments. Half (50%) of patients responded that there was more than 50% overall improvement. There were no severe adverse events. Histologic examination demonstrated increases in collagen and elastic fibers in the dermis. Conclusions: Results of this preliminary study suggest that injectable dermal poly D, L‐lactic acid can significantly affect skin rejuvenation without causing any serious adverse events. [ABSTRACT FROM AUTHOR]

Background: Wrinkle formation is the most visible characteristic of facial aging. Radiofrequency (RF) technology is currently utilized to reduce facial wrinkles and contribute to skin rejuvenation. Objective: To analyze the efficacy and safety of a noninvasive, home‐based RF device applied for facial rejuvenation in Chinese people. Methods: A single‐center, open‐label, intraindividual controlled trial was performed on subjects who received an 8‐week treatment of the RF device. A total of 22 female individuals aged 25–60 years with Fitzpatrick skin type III–IV were enrolled. Efficacy of treatment was subjectively evaluated using the Fitzpatrick Wrinkle Classification Scale (FWCS) assessed by physician or overall satisfaction of subject with a 10‐point VAS, and objectively using the skin ultrasound examination as well as the 3D skin analysis system. Adverse event was recorded at each visit. Results: In comparison with the baseline, evaluator‐assessed FWCS scores showed significant improvement at 4 weeks (p < 0.005) and 8 weeks (p < 0.005) after treatment. All subjects reported different degrees of improvement in facial wrinkles after 8 weeks of treatment. The results of skin ultrasound examination revealed significant increase of the dermal thickness at week 8 (p < 0.05) as compared to the baseline. In addition, a significant decrease in the proportion and density of perioral wrinkles evaluated by the 3D skin analysis system was observed from baseline to week 4. The treatment was well‐tolerated, and no serious adverse event was observed. Conclusion: This noninvasive, home‐based RF device was effective in improving skin texture and elasticity with a safe and well‐tolerated treating procedure. [ABSTRACT FROM AUTHOR]

Background: The most visible sign of facial aging is often seen in the periocular area. However, periocular rejuvenation remains challenging due to the particularity of periocular anatomic locations. Aims: We aimed to evaluate the efficacy and safety of the fractional‐ablative CO2 laser‐facilitated recombinant human collagen permeation in periocular rejuvenation. Patients/Methods: This 3‐month prospective single‐blinded and self‐controlled trial enrolled 26 patients with periocular aging who underwent the treatments of fractional‐ablative CO2 laser along with laser‐facilitated recombinant human collagen permeation. Following the treatments, the patients were quantitatively assessed by various periocular skin aging indices before and after the treatment and monitored for any related adverse events. Results: The patients showed significant improvements with the periocular skin aging indices 3 months after the treatments, which were detailed with a 47.3% decrease in lower eyelid skin rhytids, a 41.4% decrease in the lower eyelid skin texture, a 35.0% decrease in the static crow's feet, a 29.3% decrease in the amount of upper eyelid laxity, and a 20.2% increase in the MRD1 as compared with baseline (p < 0.05). Moreover, total skin thickness under ultrasound was increased in both upper and lower eyelids (5.6% and 3.3%, p < 0.05, respectively). Moreover, six patients (23.1%, 6/26) had erythema for 2 weeks, and two (2/26, 7.7%) had mild hyperpigmentation for 3 months. Conclusions: Fractional‐ablative CO2 laser combined with laser‐facilitated recombinant human collagen permeation can be a safe and effective treatment for periocular rejuvenation. [ABSTRACT FROM AUTHOR]

Background Facial rejuvenation has long been dominated by surgical techniques that act on only two dimensions of the face, ignoring the third dimension (facial volume); therefore, a truly youthful look remains elusive. Objectives This paper aims to define the various surgical procedures employed by cosmetic surgeons that can be combined with alloplastic implants or injectable devices in order to restore lost facial volume. Methods and materials A search of the literature was performed. Results Alloplastic augmentation and implants provide permanent restoration of facial volume, but require invasive surgery. Soft-tissue fillers include autologous fat, calcium hydroxylapatite, and a variety of polymers. Devices based on collagen and hyaluronic acids provide correction of superficial lines and folds, but cannot offer long-lasting restoration of facial volume. The only fillers that have been proven to augment facial volume are autologous fat, calcium hydroxylapatite, poly-l-lactic acid, polyacrylamide, poly-alkyl-imide, and methylpolysiloxane. Conclusions For optimal facial rejuvenation, the accepted surgical techniques of skin lifting and tightening could be combined with volumizing devices, thereby addressing ptosis, lines, folds, and volume loss. [ABSTRACT FROM AUTHOR]

Background: Injectable poly‐L‐lactic acid (PLLA) has been proven safe and effective with numerous medical applications for more than 25 years. The product has been approved in over 40 countries and is being used for soft tissue augmentation in the face and certain body parts. With the increased demand for subtle and natural‐looking aesthetic treatments in the Asia‐Pacific region, there is also a heightened need for consistent preparation and effective treatment methodologies to optimize outcomes for Asian patients. Methods: The body of evidence in medical literature, clinical data of presented case reports, and the collective experience of the authors are reflected in these consensus recommendations, which also take under consideration the availability of biostimulators in the Asia‐Pacific region. Results: The resulting consensus recommendations include patient selection and assessment, management of treatment expectations, appropriate preparation and storage, proper injection techniques and treatment plans, management of adverse effects, PLLA combination with other facial rejuvenation procedures, and other constructive considerations. Conclusions: In the above consensus recommendations, the authors shared their best practices in accordance with the updated preparation and treatment protocols of PLLA. These recommendations represent the clinical and real‐world techniques utilized by authors in providing PLLA treatments for Asian patients. [ABSTRACT FROM AUTHOR]

Objective: Although focused ultrasound modalities have achieved positive clinical results in noninvasive skin rejuvenation, they presented various side effects and particularly severe pain during treatment. This study introduces a microfocused ultrasound (MFU) device, ULTIGHT, to overcome the severe pain issue, providing quasi‐facial lifting. Materials and Methods: Transducer surface was imaged with a scanning electron microscope. The energies of four treatment cartridges were measured using an ultrasound power meter. In vitro experiments were performed to quantitatively evaluate the MFU thermal zones (MFUTZs) and treatment line (TL) of 10 MFUTZs. Ex vivo experiments were performed to evaluate the MFUTZs and temperature rise in tissue. Clinical trials using eight volunteers were performed to qualitatively evaluate facial lifting. Results: The MFU transducer clearly showed a smooth and no air gap surface. ULTIGHT produced 10 discrete MFUTZs in a TL of length 10 mm. In ex vivo tissue, discrete linear MFUTZs were clearly observed at lower number of TLs; however, they started to aggregate at higher number of TLs. The temperature rise was linearly increased as a function of the number of treatments. A single MFUTZ resulted in a temperature rise of 3°C–10°C that could cause hyperthermia for body temperature. In the clinical trials, the volunteers showed quasi‐facial lifting right after treatment on the lower facial region. Conclusions: ULTIGHT provides relatively low energy, which may be advantageous or disadvantageous depending on clinical applications. Additionally, it has the advantage of being pain‐free even without anesthetic during treatment, providing quasi‐facial lifting right after treatment. [ABSTRACT FROM AUTHOR]

Background: Several elements, including age, influence judgments of beauty and attractiveness. Aging is affected by intrinsic factors (e.g., genetics, race/ethnicity, anatomical variations) and extrinsic factors (e.g., lifestyle, environment). Aims: To provide a general overview of minimally invasive injectable procedures for facial beautification and rejuvenation to meet the aesthetic goals of patients across their lifespan, organized by decade. Methods: This case study review describes aesthetic considerations of females in their third to sixth decade of life (i.e., 20–60 years of age or beyond). Each case study reports the treatments, specifically botulinum toxin type A and soft tissue fillers, used to address aesthetic concerns. Results: Signs of aging, as well as aesthetic goals and motivations, vary by age groups, cultures, and races/ethnicities. However, there are overarching themes that are associated with each decade of life, such as changes in overall facial shape and specific facial regions, which can be used as a starting point for aesthetic treatment planning. Appropriate patient selection, thorough aesthetic evaluation, product knowledge, and injection technique, as well as good physician‐patient communication, are essential for optimal treatment outcomes. Conclusions: Nonsurgical facial injectable treatments can successfully enhance and rejuvenate facial features across different age ranges. A comprehensive understanding of facial aging and the aesthetic considerations of patients by the decade contributes to optimal treatment planning and maintenance. [ABSTRACT FROM AUTHOR]

Background: There are many aesthetic treatments aimed at combating aging. In the most common and frequently used ones there are often side effects, albeit minor ones. However, sometimes it is necessary to use medications before or after treatments. Objectives: To evaluate the anti‐aging efficacy and application safety of a therapy based on the combination of vacuum and electromagnetic fields (EMFs). Methods: A retrospective study was conducted to evaluate the aesthetic effects of the treatment on 217 subjects. Before treatment (T0) and after the last session (T1), skin hydration levels, the amount of sebum present and the pH were measured. The presence of discomfort during the sessions and side effects at T1 was verified. At T1, the levels of satisfaction of the patients and of the doctors who performed the treatment were assessed. At 3 and 6 months of follow‐up the aesthetic results were re‐evaluated. Results: For all treated subjects, an evident qualitative improvement was observed in the quality of the skin of the neck and face, with an increase in tone and a reduction in wrinkles. The instrumental tests highlighted a normalization of skin hydration, pH, and sebum values. High levels of satisfaction at T0 and good stability of results up to 6 months of follow‐up were reported. No discomfort was referred during the treatment sessions, nor any side effects after the entire treatment. Conclusions: The treatment that exploits the synergy between vacuum and EMFs is very promising given the effectiveness and safety of the technique. [ABSTRACT FROM AUTHOR]

Background: Fractional carbon dioxide (CO2) laser resurfacing is used successfully for facial rejuvenation. Post procedure skincare is a variable that influences downtime caused by pain/tenderness, erythema, crusting, and bruising. Aims: The primary objective of this pilot study was to demonstrate the benefits of human platelet extract (HPE) (plated)™ CALM Serum, a new topical cosmetic product, following fractionated CO2 ablative laser resurfacing treatment to the entire face versus standard of care. Methods: In a single‐center, randomized, evaluator‐blinded pilot study, a total of 18 subjects were randomized into two groups, CO2 facial resurfacing followed by post‐procedural standard of care (Stratacel silicone gel) or CO2 facial resurfacing with the addition of HPE renewosomes in the CALM Serum. Results: CALM Serum demonstrated statistically significant less crusting at Day 10 compared to the control group (p = 0.0193) with less downtime in the first 14 days (p = 0.03). Subjects treated with CALM Serum had statistically significant brighter appearing skin at 14 days (p = 0.007) and more youthful looking skin on Days 14 and 30 (p = 0.003 and 0.04, respectively). Conclusions: This study demonstrates that Renewosome™ technology provides statistically significant post‐laser clinical recovery over silicone gel for reducing crusting, and downtime. Subjects reported less diary days of symptoms of pain/tenderness, redness, crusting/flaking, bruising, and itching in the first 14 days compared to the control group. CALM also demonstrated statistically significant improvements in brighter and more youthful appearing skin. CALM is safe and well tolerated. [ABSTRACT FROM AUTHOR]

Background: Due to the great importance of the face in social interaction, minimally invasive treatments can—besides their ability to rejuvenate and enhance beauty—also change the way facial impressions of a person are perceived. In recent literature, three main character traits (attractiveness, trustworthiness, and competence) and subdomains essential for facial perception were described. Objective: To investigate whether minimally invasive procedures truly influence different character traits when evaluated by independent, objective observers. Methods: Photographs of n = 34 female faces before and after treatment with injectable fillers and botulinum toxin were rated by 393 individuals without aesthetic background with regards to different character traits on a 7‐point Likert scale. Tests for dimensionality were performed, and composite scores of the impressions underlying each of the three dimensions were created and compared using within‐subjects t tests. Results: Treatments statistically significantly improved the overarching character trait domains attractiveness, trustworthiness, and competence in posttreatment photographs compared with pretreatment. Posttreatment ratings of the respective subdomains also showed a statistically significant difference compared with pretreatment photographs, with the exception of the subdomain dominance which failed to reach statistical significance. Conclusion: Impressions of facial attractiveness, trustworthiness, and competence can be improved by injectables while the naturalness of the face is left intact. An implication is that the improvement of traits highly relevant to social interaction will accommodate the patient's desires for beautification and rejuvenation. [ABSTRACT FROM AUTHOR]

Background: Cosmeceutical preparations containing growth factors (GFs) are widely used for facial rejuvenation. Objective: We performed a systematic review to assess the evidence regarding their safety and effectiveness for facial rejuvenation. Methods: Electronic databases (Cochrane Library, EMBASE, MEDLINE, and Scopus) were searched from 2000 to October 2022 for prospective trials and case series assessing topical GF preparations for facial rejuvenation in 10 or more participants. Results: Thirty‐three studies, including 9 randomized controlled trials (RCTs) and 24 uncontrolled case series, representing 1180 participants receiving 23 different topical preparations containing GFs met the inclusion criteria and were included. Of the 33 studies, nine used a placebo or active control. The GF preparations were applied twice daily in all except two studies, with a mean treatment duration of 3 months. Based on the investigator's assessment, preparations containing GFs induce a modest improvement in skin texture (median < 50%), fine lines/wrinkles (median < 35%), and overall facial appearance (median < 20%) versus baseline. Participant‐assessed improvement was generally higher than investigator‐assessed response. Three comparative RCTs showed no statistically significant differences between treatments. Studies were limited by heterogeneity with regard to the source and number of GFs used in the preparations, information about additional ingredients, and lack of standardization in the outcome measures. The preparations were associated with a low risk of adverse events. The persistence of the clinical improvements beyond 6 months is not known. Conclusions: Administration of topical preparations containing GFs appears to be effective for facial skin rejuvenation, as demonstrated by the investigator‐ and participant‐reported outcome measures. [ABSTRACT FROM AUTHOR]

Background: Facial wrinkles and sagging are the most visible signs of aging and can cause profound distress. Microneedle fractional radiofrequency (MFR) is a minimally invasive procedure, which utilizes both microneedling and radiofrequency energy to rejuvenate the skin. Objective: To describe the safety and efficacy of a temperature‐controlled MFR device on facial fine lines and laxity. Patients and Methods: A retrospective chart & histology review was performed on individuals who received bipolar MFR for facial rejuvenation. A total of 15 Koreans with a median age of 46 years were included. All participants underwent a single treatment session. The results were assessed objectively using serial photography and subjectively based on the participants' satisfaction scores. Histologic changes before, immediately after MFR and at 4 months follow‐up was examined. Complications were also recorded. Results: Partially denatured collagen fibers and dermal shrinkage was observed immediately after MFR whereas an increase in elastin and collagen was noted at 4 months follow‐up. 86.7% of recipients considered the results satisfactory. Consensus ratings by two independent dermatologists on the objective outcomes at 4‐month follow‐up were very much improved (53.3%), much improved (26.7%) and improved (20%). Treatment was well tolerated and did not cause any significant long‐lasting discomfort. Conclusion: Temperature‐controlled bipolar MFR is a minimally invasive treatment option to consider for facial fine lines and laxity via neo‐collagenesis and neo‐elastogenesis. The procedure was safe and clinically effective. [ABSTRACT FROM AUTHOR]

Background: Exosome research continues to flourish. Subsequent knowledge surrounding indications, dose–response, safety, efficacy, and the ability to combine exosome treatment as a "skin primer"—for biostimulation modalities such as calcium hydroxylapatite (CaHA), platelet‐rich plasma (PRP), and platelet‐rich fibrin matrix (PRFM) is growing rapidly. The objective of this study was to develop safe, reproducible methods of improving topical exosome absorption to enhance the quality of skin either by themselves, or in combination with injectable CaHA. Methods: Under IRB Approval (International Cell Surgical Society: ICSS‐2022‐007), 40 patients were enrolled in this study. Twenty patients underwent facial biostimulatory dermal infusion alone, to determine if this method allowed adequate exosome absorption. Five patients underwent facial biostimulatory infusion followed immediately by Dilute CaHA injection (1:1 dilution) to the face. Five patients underwent exosome biostimulatory dermal infusion followed immediately by hyperdilute CaHA (dilution 1:4) injection to the neck. Five patients underwent Facial Dilute CaHA injection (1:1 dilution) alone, without dermal infusion. Five patients underwent neck hyperdilute CaHA injection (1:4 dilution) alone, without dermal infusion. All patients had pretreatment Quantificare 3‐D photo‐documentation and skin analysis (Quantificare, France). In all patients, the skin was first cleansed with a gentle glycolic acid facial wash (Gregory MD). To induce a "homing inflammatory environment" for the exosomes, sea salt exfoliation was performed (SaltFacial®, SaltMed, Cardiff, CA). A nitric oxide—generating serum (N101 Pneuma Nitric Oxide, Austin, TX) was then applied to act as an enhanced vehicle for absorption. A 3 MHz ultrasound (SaltFacial®, SaltMed, Cardiff, CA) was then utilized to further deepen the absorption of the nitric oxide serum. A topical emulsion containing equal volumes (1.0 cc containing 1 million) of exosomes (Kimera Labs, Miramar, FL), 25 units of botulinum toxin (Xeomin, Merz Aesthetics, Raleigh, NC) and hyaluronic acid (Belatero, Merz Aesthetics, Raleigh, NC) was mixed via back‐and‐forth propulsion in a 3‐cc syringe. When adequately mixed, the emulsion was then applied to the treatment areas. The cavitating ultrasound was then used to aid in the absorption of the emulsion. The patients were then treated with high‐intensity LED therapy (SaltFacial®, SaltMed, Cardiff, CA), utilizing the collagen restoration preset program of combination red (660 nm) near‐infrared (930 nm) wavelength for 20 min. Post‐treatment Quantificare analysis was performed at 15 and 30 days after treatment. Results: Without exception, all dermal infusion alone and CaHA injection alone patients showed an improvement in the tone, quality, and texture of their skin. Quantificare results showed consistent improvement in wrinkles, pores, skin evenness, improved vascularity, and a reduction in oiliness and unwanted pigment. When employed as a skin primer prior to injections (CaHA), enhanced and more rapid results were seen. Conclusions: Biostimulatory dermal infusion can be achieved utilizing topical placental mesenchymal stem cell‐derived exosomes. These exosomes can be used alone, or mixed with ancillary ingredients such as botulinum toxin, hyaluronic acid dermal filler, and CaHA to customize and personalize treatments based upon individual patient needs. Topical absorption is enhanced with sea salt exfoliation, a topical nitric oxide‐generating serum, and 3 MHz cavitating ultrasound. Post‐absorption activity is enhanced with high‐intensity LED treatment. The addition of CaHA injections after the topical exosome "priming of the skin" yielded enhanced skin quality faster than exosomes or CaHA alone. [ABSTRACT FROM AUTHOR]

Background: Age‐related changes to the face pertinent anatomy and important aspects of autologous fat grafting have been widely applied in facial rejuvenation. Various types of autologous fat products (Macrofat, Microfat, SEFF, nanofat, and SVF‐gel) with different properties and applicabilities have been introduced and available for surgeons. Methods: Key differences between common techniques for fat processing and infiltration. Develop a plan for patients based on site‐specific facial anatomical zones, we suggested a pyramidal multiple‐theory (multi‐type, multi‐method and multi‐layer) for facial fat grafting. Based on the complicated mechanism of the face decrepitude in different layers of facial soft tissue, autologous fat products with various particle sizes and components into different layers. Results: Fifty‐eight patients underwent this facial fat grafting strategy from June 2020 to Jan 2022. All achieved cosmetic improvements, with higher patients' satisfaction, and minor complications. Our facial fat grafting strategy takes advantage of different fat products and is able to address the physiological tissue changes during aging, more properly and targetedly, than the traditional facial fat grafting. Conclusions: Fat grafting to the face aids in volume restoration and rejuvenation, thereby addressing soft‐tissue atrophy associated with the aging face, acquired conditions, or congenital malformations. The technique described as "lipo‐tumescence" has been successfully used in the breast and other regions of the body that have radiation damage and is discussed in this article specifically for the face and neck. [ABSTRACT FROM AUTHOR]

Background: Hair loss is affecting over half of the population worldwide, leading to noticeable psychotic disorders in a considerable proportion of patients. The current treatments remain unpredictable and disappointing. Objective: This study aimed to evaluate the efficacy and safety of fractional lasers compared with other conventional treatments as either mono or combined therapy in the treatment of alopecia. Methods: We have conducted a thorough literature search in PubMed, Web of Science, Embase, Cochrane library, and China national knowledge infrastructure databases (from inception to February 9, 2022). Relevant clinical trials, mainly randomized controlled trials, were included, regardless of their comparisons. The Cochrane risk of bias assessment was used for quality appraisal. Outcomes were evaluated by efficiency rate, hair density, etc. Results: Thirteen controlled clinical trials, including nine randomized controlled trials, with 606 patients were retrieved. As an individual therapy, the fractional laser is superior to any other therapy in total efficiency (RR = 1.58, 95% CI: 1.16–2.14, p = 0.003). When the fractional laser was applied in combined treatments, the result showed a significant difference (RR = 1.23, 95%CI: 1.02 to 1.49, P = 0.03) compared with other treatments. Although both mono and adjunctive groups were confirmed to be efficient, there were no statistical differences between the two of them (RR = 1.24, 95% CI: 0.87–1.77, p = 0.24). Conclusion: Our results showed that the fractional laser has a significant efficacy as either mono or adjuvant therapy. Further research and exploration of fractional lasers with larger sample sizes are required to confirm the efficiency and safety of this treatment. [ABSTRACT FROM AUTHOR]

Background: Treatment with hyaluronic acid (HA) fillers as a strategy for rejuvenation has experienced a significant growth in recent years, accompanied by a parallel increase in its complications, the treatment of which, such as hyaluronidase, we must be aware of. Patients/Methods: 14 patients (28 eyes) had indication for upper blepharoplasty surgery in the Hospital Universitario y Politécnico La Fe. After surgery, periocular skin of one eye of each patient was infiltrated with 300 U of hyaluronidase (14 cases) while the skin of the fellow eye was preserved untreated (14 controls). All samples were studied by the Pathology department, and finally, 6 variables (skin structure alteration, degeneration of elastic fibers, deposits, collagen fibers destructuring, inflammation, and other findings) were analyzed. Results: No differences in skin structure, elastic fibers, and collagen dermal fibers were found between hyaluronidase‐treated skin and controls. A significant association between ex vivo application of hyaluronidase in periocular skin and the presence of amorphous extracellular deposits within the dermis was found. Conclusions: Hyaluronidase applied ex vivo to periocular skin led to presence of deposits within the extracellular matrix compared to control eyelid skin but elastin and collagen dermis structure remained unaltered. [ABSTRACT FROM AUTHOR]

Background and Objective: As a minimally invasive procedure, mesotherapy has been used in the cosmetic field for half a century and gets favorable results in fat reduction, facial rejuvenation, and hair regrowth. So far, it has achieved some exciting progression in pattern hair loss (PHL), which bothers plenty of people and has cost billion dollars searching for more effective treatment. The aim of this study is to summarize the efficacy of mesotherapy treating PHL. Methods: Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, and Web of Science were searched until January 2021. All literature was evaluated according to established criteria. Results: We got 336 studies from searched databases, and 12 studies were included after selection process. A total of 253 males and 274 females participated in 6 randomized control trials, 2 nonrandomized controlled trials, and 3 observational studies. Mesotherapy showed positive efficacy in all studies to a certain extent, and no significant side effect occurred. Conclusion: Mesotherapy demonstrated as an effective treatment for PHL. However, the sample size is not big enough, and studies about mesotherapy compared to other treatments are insufficient. Future research is required to claim more evidence. [ABSTRACT FROM AUTHOR]

Background: A new hyaluronic acid (HA) formulation was developed based on high molecular weight (MW) compounds used on the surface of the skin while using peptides to stimulate the high MW HA production by fibroblasts and keratinocytes from within the skin layers. Detailed science has been submitted to this journal in a previous publication. This multicenter study aims to validate the science by demonstrating the safety and efficacy of the product in the clinical realm. Objectives: This study evaluated the efficacy and safety of a topical HA serum in facial skin. Methods: An open‐label clinical study was undertaken over 4 months from November 2021 to March 2022. Participants applied the topical serum twice daily and were provided a gentle cleanser and an SPF 30+ to use in the morning. Follow‐up visits were conducted at weeks 2, 4, and 8. At every visit, participants were measured for hydration post 15 minutes of cleansing the skin and post 15 minutes of product application for cumulative skin hydration sensor measurements. Additional procedures included participant assessments and satisfaction, investigator assessments, biopsies, and photography. Results: At each follow‐up visit, there was an increase in hydration measurements compared to baseline, in both immediate scores and cumulative long‐term scores. At weeks 4 and 8, there was a statistically significant increase in hydration compared to baseline and the prior visit. Participants' assessments progressively increased over 2‐, 4‐, and 8‐week intervals with significantly favorable ratings in all measured parameters. Similarly, investigator assessment grades were statistically significant (p < 0.0001) for decreased fine lines/wrinkling, crepiness, texture, erythema, and dryness, and increased (p < 0.0001) for moisture/hydration. Histology revealed increased CD44 staining in 6 of the 7 participants biopsied, denoting increased HA stimulation. In all of the participant biopsies, H&E staining demonstrated improvement in solar elastosis. Photography revealed remarkable improvement in erythema, tone, and texture. Conclusions: The study results demonstrated that the formulation produced significant improvements in immediate and long‐term hydration effects on the skin as measured by the skin hydration sensor, 'wearifi' technology, comparison of before and after biopsies, and participant and investigator assessments. This high MW HA formulation produced excellent clinical improvement in skin health and hydration. [ABSTRACT FROM AUTHOR]

Background: The use of hyaluronic acid (HA) fillers for medical aesthetic purposes is increasing worldwide. Nonetheless, adverse events do occur because of patient‐specific issues, injection technique, or product factors. It would be mandatory to consider cultural and anatomical features of Asians in preventing and managing the complications of HA injections. Methods: Literature search of studies looking at current evidence and guidelines on the management of complications following HA filler injections in Asian patients was conducted. This was followed by an expert group discussion that was convened to reach consensus recommendations on the best clinical practices. Results: The expert panel provided specific recommendations focusing on the safe use of soft tissue fillers in Asian patients, including early identification of adverse events and how to prevent and comprehensively manage these outcomes. Conclusions: Here, we provide consensus statements of Asian experts in dermatology, plastic surgery, ophthalmology, and aesthetic medicine mainly focusing on AEs with higher risk for Asians and can be used to guide physicians in treating Asian population. [ABSTRACT FROM AUTHOR]

Background: Hyaluronic acid fillers have been studied extensively for facial wrinkles; however, their efficacy for atrophic facial scars has yet to be analyzed in a prospective placebo‐controlled study. Objective: To analyze the efficacy and safety of a hyaluronic acid filler for atrophic facial scars. Methods & Materials: Fifteen subjects were randomized to receive up to 1 ml of VYC‐17.5 L on one cheek and up to 1 ml of saline on the other side, with an optional touch‐up treatment. Subjects were graded by a live blind evaluator using the Quantitative Global Scarring Grading System (QGSGS) (J Cosmet Dermatol. 2006;5:48), the Global Aesthetic Improvement Scale (GAIS), and Canfield photo‐analysis. Results: According to the blind evaluator, there was a significant reduction 90 days after the last treatment on the QGSGS for VYC‐17.5L compared with saline (−6.6 VYC‐17.5L vs −1.7 saline [t(28) = −4.3196, p = 0.008]). There was a smaller, but still significant reduction on the QGSGS for saline alone (10.4 to 8.6 [t(14) = −3.453, p = 0.004]). In addition, 93% (13/14) of subjects chose VYC‐17.5L over saline treatment and reported an improvement on the GAIS. There were no serious side effects and all minor side effects resolved by Day 30. Conclusion: VYC‐17.5L achieved significant improvements in rolling atrophic scars as compared to saline, though saline also had modest improvements. [ABSTRACT FROM AUTHOR]

Background: Tissue fillers are among the most popular cosmetic procedures performed and notably, cases of filler reactions after COVID‐19 vaccination have been reported. Objective: The objective was to determine the characteristics of patients with filler reaction after COVID‐19 vaccination and address several considerations that have to be taken into practice. Methods: A PRISMA compliant systematic search was conducted in Scopus, Web of Science, and PubMed/MEDLINE databases for articles published from inception up to October 21, 2021. Results: Out of 106 initially retrieved articles, four of them were included in our study, and a total number of 13 cases were analyzed. In this study, we found that all of the patients who developed delayed‐type reaction (DTR) following COVID‐19 vaccination were middle‐aged women without any known history of allergy to foods or drugs. All patients had a history of hyaluronic acid (HA) filler injection in their head and neck and demonstrated symptoms particularly swelling, from <1 day up to 10 days after the first or second doses of vaccines. Lisinopril, hyaluronidase, and corticosteroids seemed to have good results in management. Conclusion: Although rare, DTR to fillers after COVID‐19 vaccination can happen. Physicians should be aware of the pathogenesis and management of this phenomenon. [ABSTRACT FROM AUTHOR]

Background: Monopolar radiofrequency (MRF) for facial rejuvenation works by diffusely heating the dermis and subdermal fibro‐septal network. Immediate collagen contraction and long‐term neo‐collagenesis produce antiaging effects. Aim: To lift and repose drooping fat planes along their vectors of descent to restore natural, youthful contours using MRF and to objectively measure, quantify, and analyze the antiaging effects of MRF on the backdrop of functional facial anatomy. Methods: This was a prospective study on 30 subjects aged 25–65 years who underwent three sessions of MRF (Exilis, BTL Aesthetics) with a modified protocol at weekly intervals. Clinical evaluation at baseline and 4 weeks after the final session was done according to the global drooping and wrinkles classification and scoring system (GDWCSS) and statistically evaluated. Two patients were analyzed with Ultrasound and Vectra‐H1 imaging for change in subcutaneous fat depth and volume over different facial areas, respectively. Results: There was improvement in all parameters (volume alteration and wrinkles) of the GDWCSS, of which improvement in cases that had baseline severe (grade‐4) temporal fat loss, malar fat loss, periorbital hollowing, and puffiness was statistically significant. The results of imaging supported the clinical findings. Conclusion: Monopolar radiofrequency targets facial collagen as deep as the facial fat, thereby achieving "reversal" of the grooves and bulges of aging with volume re‐distribution and favorable "remolding" of fat pads. The result is simultaneous skin tightening, lifting and contouring in manner that is natural, regenerative, and corrective. Given its versatility, efficacy, safety, and tolerability, it is emerging as a power‐player in the dermatologist's antiaging armamentarium. [ABSTRACT FROM AUTHOR]

Background: Nonsurgical reshaping of the nose, chin, and jawline with hyaluronic acid fillers is becoming increasingly popular. Appropriate patient selection is essential. Objectives: To assess the safety and efficacy of nonsurgical treatment of these facial areas using experience‐based eligibility criteria and injection of the high G' filler, VYC‐25L. Methods: This was a retrospective analysis of patients undergoing aesthetic improvement of the nose, chin, and/or jawline with VYC‐25L, selected based on detailed criteria derived from extensive experience and imaging assessments. In a subgroup of subjects, high‐resolution 3D imaging was used to assess nasal angles, nasal hump height, and chin projection. Results: A total of 135 patients were included (n = 106 females; mean age, 43.4 ± 14.3 years; n = 44 nose treatment only, n = 24 chin/jawline only, n = 67 both). Mean treatment volume was 3.3 ± 2.0 ml. In total, 111 individuals (82.2%) were injected in the nose (mean volume: 0.9 ± 0.2 ml) and 91 (67.4%) in the chin/jawline (mean volume: 3.8 ± 0.8 ml). Most complications were injection site‐related (bruising, n = 27 [20.0%]; pain, n = 1 [0.7%]). One patient (0.7%) experienced lip herpes, successfully managed with antiviral therapy. Thirty‐two individuals underwent 3D imaging, which showed substantial mean changes from baseline in nasofrontal angle (3.5 ± 1.6 degrees), nasofacial angle (2.2 ± 0.8 degrees), and nasolabial angle (3.9 ± 2.6 degrees); decreases in nasal hump height (1.7 ± 0.9 mm); and increased chin projection (2.7 ± 1.5 mm). Conclusions: Nonsurgical reshaping of the nose, chin, and jawline was safe and effective using experience‐based eligibility criteria and VYC‐25L. [ABSTRACT FROM AUTHOR]

Introduction: There are currently not many publications on the safety of thermomechanical ablation (TMA) devices, and those that are published only have small numbers of subjects. This treatment is gaining popularity in Europe and Asia, and thus there is a need to look at the safety of this treatment. Objective: The purpose of this retrospective study was to evaluate the safety of the clinical use of the novel TMA system (Tixel, Novoxel, Israel) for facial rejuvenation and treatment of acne scars. Methods: We did a retrospective review of our first 150 patients who were treated with the TMA device. Results: One hundred and fifty consecutive patients aged 20 years to 82 years with Fitzpatrick skin types I to V treated with the TMA device were included in this study. The total number of treatment sessions was 327 (average 2.18 treatment per patient). The total number of pulses delivered to these patients was 1 48 856 (average 455 pulses per session). The indications for the treatment were photodamaged skin (n=145) and acne scarring (n=5). All patients were able to use makeup immediately after the treatment at lower settings, thus needing no real recovery time. Patients treated at higher settings were able to use makeup after 2 days. There were four reported complications: post‐inflammatory hyperpigmentation (n=2), impetigo (n=1), and dermatitis (n=1). Conclusions: Using the TMA device in the treatment of photodamage and acne scarring is safe in skin types I to V and has a low incidence of temporary side effects with no permanent side effects. [ABSTRACT FROM AUTHOR]

Background: Hyaluronic acid (HA) fillers are known to be effective for the correction of facial wrinkles and folds, but there is no clinical study that compares the efficacy of small‐to‐medium‐particle HA fillers and large‐particle HA fillers for the correction of nasolabial folds (NLFs). Moreover, injection depth also plays an important role in the correction of NLFs as well as improvement of facial aesthetics. Objectives: To assess the efficacy, safety, and durability of a small‐to‐medium‐particle HA filler, Restylane, and a large‐particle HA filler, Yishumei, as well as the effect of injection depth in the correction of moderate‐to‐severe NLFs and facial aesthetics in a Chinese population. Methods: This 52‐week, prospective, randomized, double‐blind study enrolled 100 participants with moderate‐to‐severe NLFs. The participants were randomized to receive either Restylane (Group A) or Yishumei (Group B). Group A and Group B were further randomly divided into a superficial injection group (Group A1 & B1) and a deep injection group (Group A2&B2) according to injection depth. Improvement in the Wrinkle Severity Rating Scale (WSRS) score and Global Aesthetic Improvement Scale (GAIS) and participants' satisfaction were evaluated as endpoints. All adverse events were monitored throughout the study. Results: The treatments were well tolerated by all the participants. All four groups showed a reduction in their mean WSRS scores and GAIS scores by week 12. At week 24, the WSRS and GAIS scores did not change in Group A1 and A2, while participants in Group B1 and Group B2 had higher WSRS and GAIS scores than those in the previous weeks. By week 52, the WSRS scores in all the groups returned to almost baseline levels. The mean FACE‐Q scores increased compared with the baseline scores in all groups through week 24. Most participants were satisfied with their treatment, and no meaningful differences were found between the fillers in terms of participant satisfaction. The most common adverse events were swelling, redness, and tenderness at the injection site, but they resolved spontaneously without treatment. Conclusion: The two HA fillers had good therapeutic effect on NLFs in the early stage of treatment, but Restylane had a more prolonged effect. Moreover, compared with the superficial injection, the deep injection provided slight midface lifting and improved facial aesthetics. [ABSTRACT FROM AUTHOR]

Objectives: Tear trough deformity (TTD) is becoming a growing concern for those seeking facial rejuvenation, and various treatment strategies have been reported. Among treatment options is micro‐autologous fat injection, which appears to be an effective approach to recontour the tear trough in the young. The study we present here investigated the reliability and effectiveness of two‐dimensional fat injections (TDFI) in the treatment of young patients with TTD. Methods: This study evaluated patients with TTD who underwent TDFI between December 2018 and December 2020. The proposed procedure involved ligament releasing and fat injection into the tear trough in two different directions. Results: The average age of the 102 enrolled patients was 25.9 ± 3.8 years. Significant improvement and maintenance of TTD were observed during the follow‐up period (13.2 months average) with no major complications being observed. Improvement of dark cycles and enhanced aegyo sal were observed. Patient satisfaction based upon self‐administered post‐procedure questionnaires disclosed that 58.8% were very satisfied, 38.2% were satisfied, and 2.9% neutral with the results. Conclusions: Two‐dimensional fat injections is an effective and reliable method with high satisfaction and low risk of complication. Long‐term results demonstrated its utility for young‐type TTD. [ABSTRACT FROM AUTHOR]

(C) Quantitative analysis of the nasolabial folds before treatment and 1 month after treatment. We investigated 41 female participants aged 25-48 (range, 33.8 ± 5.89) years with Fitzpatrick skin types III-IV, and minimal-to-moderate skin aging as validated by a skin aging scale.5 A total of 26 participants were objectively measured immediately after MRF treatment. *p < 0.05 gl Our data demonstrated that both the marionette lines and nasolabial folds improved objectively after treatment in a relatively short time, although no subjective changes in the nasolabial folds and marionette lines were observed at 1 month after treatment. [Extracted from the article]

Background: Restoration of an esthetic neck contour is an integral component of facial rejuvenation. The corset platysmaplasty and the suture suspension neck lift were introduced by Feldman in 1990 and by Giampapa in 1995, respectively. Both techniques are routinely used in current practice with satisfactory and long‐lasting results. However, some patients who have undergone the suture suspension platysmaplasty report long‐term discomfort, excessive neck tightening, and recurrence of deformity. Objective: To achieve an improvement in the Cervicomental (CM) angle and other parameters in patients with a difficult neck and to reduce the probability of long‐term discomfort, excessive neck tightening, and a recurrence of deformity. The author developed a new technique that includes a very wide suture suspension with no interlocking. We hereby present a revised suture suspension technique—The Wide Suture Suspension Platysmaplasty. Methods: Between the years 2015 and 2017, the senior author performed 286 face and neck rejuvenation surgeries with or without blepharoplasty. Of these cases, 35 patients with a heavy neck were chosen for the new Wide Suture Suspension Technique. This was a single surgeon retrospective cohort study. Patients were photographed in a lateral view preoperatively and 6 months postoperatively. Pre‐ and postoperative photographs were compared in four measured parameters: the cervicomental angle, the jowl angle, the horizontal distance between the mentum and the cervicomental angle and the vertical distance between the mentum and the cervicomental angle. Results: The Wide Suture Suspension Platysmaplasty resulted in pleasing esthetics, with minimal complications in patients with difficult necks. The cervicomental angle decreased by 42° (P <.0001), the jowl angle increased by 12° (P <.0001), the horizontal distance between the mentum and the cervicomental angle rose by 12.4% and the vertical distance between the mentum and the cervicomental angle was reduced by 34.5%. Conclusion: The Wide Suture Suspension Platysmaplasty resulted in improved esthetics, as demonstrated by objective measurements. None of the patients in this series had any secondary intervention during the follow‐up period. Particularly in the case of a difficult neck, surgeons should consider this technique. [ABSTRACT FROM AUTHOR]

Background: Radiofrequency (RF) is a non‐invasive or minimally invasive procedure with a low risk of complications. It has been employed for several aesthetic purposes. Aim: This study aimed to conduct a systematic literature review on the use of RF for aesthetic applications and assess the level of accumulated evidence for each condition. Methods: Using the MEDLINE/PubMed and EMBASE databases, we searched for articles published from 2009 to 2019 describing the use of RF treatment for aesthetic purposes. Results: Our search approach identified 25 randomized clinical trials investigating the efficacy of RF in the following clinical situations: body contour improvement, facial rejuvenation, acne scar treatment, alopecia, and rosacea. There were problems with the quality of the studies, especially regarding selection, performance, and detection bias. Conclusion: Our study revealed that RF treatment is potentially promising in all of the evaluated clinical situations; however, we were not able to identify a level of evidence that justifies its use over other therapeutic options currently available on the market. [ABSTRACT FROM AUTHOR]

Background: The aging of facial structures depends on genetic, anatomic, chronologic, and environmental factors that affect the skin and underlying tissues. Microfocused ultrasound with visualization (MFU‐V) has emerged as a safe and effective treatment for skin laxity. As the nutritional status may contribute to skin aging, it would be interesting to evaluate whether different dietary patterns can also influence the response to MFU‐V treatment for skin laxity. Aims: The aim of this study is to compare the outcome of MFU‐V therapy between omnivore and vegan patients. Methods: Twenty‐seven vegan and twenty‐seven omnivorous women who underwent MFU‐V treatment for laxity of lower face and neck were enrolled. The clinical outcome was evaluated using the FLR (Facial Laxity Rating) scale after 3 and 6 months from treatment. Results: At baseline, no significant differences were found in terms of FLR scale in both treated sites. After 3 months, reduction in FLR scale was significantly lower for vegans both on face (P =.04) and neck (P =.004). At 6 months, vegan patients had a worse clinical outcome on lower face (P =.001) and neck (P <.001). Conclusion: The present study suggests that a vegan diet may negatively influence the outcome of a MFU‐V treatment. [ABSTRACT FROM AUTHOR]

Background: In esthetic medicine, different techniques have been used against the aging of the human skin especially in the facial area. Hyaluronic acid is used for improving the quantity of water and extracellular matrix molecule. The aim of this study is a clinical and histological evaluation of the effect of low‐molecular‐weight hyaluronic acid fragments mixed with amino acid (HAAM) on the rejuvenation the face skin treated with intradermal microinjections. Methods: Twenty women with mean age 45 range from 35 to 64 were studied, thereof 8 in menopause and 12 of childbearing age. The patients were treated with the HAAM products by mesotherapy technique; before and after 3 months of the therapeutic procedure, each patient underwent small biopsies with a circular punch biopsy. Results: The clinical results of the present study showed that the administration of the dermal filler containing fragments of hyaluronic acid between 20 and 38 monomers and amino acid via dermis injection technique produces an esthetic improvement in the faces of the treated patients, while the histological evaluation shows an increased fibroblast activity with the production of type III reticular collagen and increased number of vessels and epidermis thickness. Conclusions: The clinical and histological assessment showed that subcutaneous HAAM infiltration has a significant impact on the dermis and clinical aspects of the face. [ABSTRACT FROM AUTHOR]

Background: Hollowing of the temple area is an early sign of aging that is often overlooked, but when corrected, can lead to significant subject and physician satisfaction. Aims: To assess physician and subject awareness of the impact of temporal hollowing on appearance and to evaluate treatment satisfaction following injection of calcium hydroxylapatite with integral lidocaine (CaHA(+)). Patients/Methods: Subjects with temporal depression grade ≥2 on a validated Temple Hollowing Scale were recruited. CaHA(+) was injected supraperiosteally using a bolus technique. Photographs were taken prior to treatment and 30 days, and graded by three evaluating physicians using the Global Aesthetic Improvement Scale (GAIS) and Temple Hollowing Scale. The same physicians estimated subjects' age before and after treatment. Photographs were graded by patients as part of a satisfaction questionnaire. Results: The study enrolled 10 subjects aged 32‐68 years old. Physician GAIS scores of subject appearance at 1 month were rated as "very much improved" in 80% and "much improved" in 20% of subjects. Temple hollows were graded as 1 after treatment in 90% of subjects. Following blinded review of patients' true ages, estimates for subjects' perceived age were on average 4 years younger than their actual age. Most subjects had not been aware of temple hollowing prior to treatment, but nine out of 10 were very to extremely satisfied with results, and all were willing to repeat treatment. No treatment complications were observed. Conclusion: Treatment of the temple area can have a dramatic aesthetic effect and should not be neglected when addressing facial rejuvenation. CaHA(+) is an effective and well‐tolerated product for use in the temple area and is associated with a high degree of subject and physician satisfaction. [ABSTRACT FROM AUTHOR]

Introduction: Aging is an inevitable process in life that can pose unsatisfactory changes in appearance. Recently, rejuvenation surgeries have opened an exciting new window toward people who are vulnerable according to their facial appearance. Periocular plastic microsurgeries are among the most common aesthetic surgeries with various outcomes. The current study was aimed to compare outcomes of blepharoplasty with and without peeling regarding lower eyelid rejuvenation. Methods: This is a randomized clinical trial study conducted on 30‐patients referred for inferior lid rejuvenation in 2017‐18. Patients were randomly divided into two 15‐member subgroups of microinvasive blepharoplasty with and without peeling. Peeling for the group underwent blepharopeeling was performed all over the inferior periocular region using Phenol 89%. Then, skin and underlying muscle were incised superficially, and underlying fat tissue was excised. The other group underwent blepharoplasty without peeling. Patients were followed daily for 2 months to assess complications, patients' and physicians' satisfaction. Results: Two assessed groups were not statistically different regarding age and gender distribution (P‐value =.417 and.666, respectively). Considering patients' opinion, symmetry, scar formation, skin laxity, swelling, and total satisfaction score were not different between two groups (P‐value >.05) while physicians presented similar outcomes except for better scar formation status of peeling add‐on therapy (P‐value =.042). Rate of adverse effects was significantly higher among those under blepharoplasty plus peeling treatment (P‐value <.05). Conclusion: Outcomes of blepharoplasty alone versus blepharoplasty plus peeling were not significantly different regarding both patients' and physicians' assessments in general while fewer complications due to blepharoplasty without peeling were presented. [ABSTRACT FROM AUTHOR]

Background: Microneedling and fractional lasers have been used in facial rejuvenation with acceptable results and low adverse effects. Aims: To compare the efficacy of microneedling with fractional Er:YAG in facial skin rejuvenation. Patients/Methods: This study was planned as a split‐face clinical trial. Volunteers were randomly allocated to receive three monthly treatments on each side of the face, one with fractional Er:YAG laser and one with microneedling. The assessments included investigating clinical outcomes by two blinded dermatologists accompanied by measuring skin biophysical characteristics including cutaneous resonance running time (CRRT) and transepidermal water loss (TEWL). Moreover, possible adverse effects, downtime, and patients' satisfaction were recorded at baseline, 1 month after each treatment, and 3 months after the last treatment session. The protocol was approved by the Iranian Registry of Clinical Trials (IRCT20160820029436N3). Results: Of the 32 selected volunteers, 24 subjects completed the study. The clinical assessment showed a significant improvement of the face appearance along with a significant reduction in dyschromia, and periorbital wrinkling (P‐value <.05), with both procedures without any considerable difference between two methods. Moreover, the patients showed substantial satisfaction with both modalities with no statistically significant difference. Mean TEWL and CRRT values also decreased significantly in both groups with no considerable difference. The downtime was significantly shorter in the microneedling‐treated side. There were no long‐lasting or severe adverse effects after treatment with both methods. Conclusion: Microneedling and fractional Er:YAG laser have comparable efficacy in facial rejuvenation, but little downtime of the former makes it preferable for many patients. [ABSTRACT FROM AUTHOR]

Objective: The objective of our study was to present the results and safety profile of fractional 1064 Q‐switched Nd: YAG laser treatment in skin rejuvenation in Indian patients with Fitzpatrick skin type III‐VI. Materials and methods: We studied our clinical data of 252 patients who underwent treatment for facial skin rejuvenation with the Q switched Nd:YAG laser 1064 wavelength, using the fractional mode of 5mm spot size with fluences from 1.2 J ~ 2 J/cm2 and the energy ranging from 300‐500 mJ, a repetition rate of 7Hz and pulse duration of 8 ns for 6 sessions at two weekly intervals. We evaluated results with the aid of clinical photography taken before start of treatment, on 3rd and 5th sessions along with patient satisfaction and dermatologist assessment scores. Any adverse events were also recorded. Results: At the end of 6 sessions, both patients and dermatologists reported visible improvement in skin texture and tone. The laser sessions resulted in an immediate improvement in skin texture and tone in the first session itself that increased over 3 sessions and then stabilized. Transient erythema was reported in a few cases. No hypo‐ or hyperpigmentation were noted. Conclusions: The 1064 QSNYL is popularly used for skin rejuvenation especially in the Asian countries. But there is lack of substantial clinical data to validate the clinical results. We present the first study that shows the fractional 1064 Qswitched ND:YAG laser is a safe and effective option for skin rejuvenation in skin types III‐VI. [ABSTRACT FROM AUTHOR]

Almost all the side effects were transient and resolved within few hours (1 erythema and 2 pain experience), a day (2 edema, 10 erythema, and 1 pain experience), or 2 days (1 edema). Keywords: esthetic medicine; microneedles; nanosoft EN esthetic medicine microneedles nanosoft 3701 3703 3 11/02/21 20211101 NES 211101 ACKNOWLEDGEMENTS All listed authors have provided a significant contribution in the study by participating in design and conduct, data entering, data analysis, patient enrollment and assessment, and manuscript preparation. Facial rejuvenation using a microneedle-based device with a revitalizing solution and free hyaluronic acid. [Extracted from the article]

Background: Platelet‐rich plasma (PRP) is a medical material with numerous applications. It produces particularly spectacular effects when applied in cosmetic dermatology. Aim: To illustrate the origin of the treatment. Conclusion: The therapy originates from transfusiology, where it is applied as a concentrate of platelets to treat trombocytopenia. PRP treatment is 70 years old and has an increasing number of applications. PRP holds particular promise for cosmetic dermatology. [ABSTRACT FROM AUTHOR]