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Following the advent of glucagon-like peptide-1 receptor agonists (GLP-1RAs), subsequent unintended effects such as accelerated facial aging and altered skin health have been noted. This review delves deeper into the causative underlying mechanisms and provides insights into the intricate relationship between GLP-1RAs, adipose tissue, and premature facial aging, thereby highlighting the need for a nuanced understanding of their effects on facial alterations and skin health. Studies exploring the potential effects of GLP-1RAs on facial alterations and offering insights into the possible underlying mechanisms, causes, and clinical implications were included. The accelerated facial aging and altered skin health observed in GLP-1RA patients appears to be multifactorial, involving loss of dermal and subcutaneous white adipose tissue, and altered proliferation and differentiation of adipose-derived stem cells (ADSCs), and impacts on the production and secretion of hormonal and metabolic factors. These changes compromise the structural integrity and barrier function of the skin and may lead to diminished facial muscle mass, further exacerbating the appearance of aging. The insights presented call for a paradigm shift in the clinical management of facial changes induced by GLP-1RAs, with a focus on treatment strategies aimed at targeting ADSC stimulation. These include autologous fat transfers to reintroduce cells rich in ADSCs for rejuvenation, composite fat grafting combining autologous fat with/without stromal vascular fraction, and the strategic use of soft tissue fillers for volume restoration and biostimulation. This review highlights the potential role of GLP-1RAs in modulating adipose tissue dynamics, thereby contributing to accelerated aging through metabolic, structural, and hormonal pathways. Level of Evidence: 5 [ABSTRACT FROM AUTHOR]

Background: The popularity of social media appears to be increasing the acceptance of cosmetic treatments, prompting more consumers to seek cosmetic treatments. As the estimated prevalence of acne vulgaris among adult women may be as high as 54%, acne is commonly observed among patients presenting for cosmetic treatments. Concomitant treatment of acne in the aesthetic patient population will improve overall clinical outcomes. Aims: The goal of this work was to deliver a high‐quality ethical and evidence‐based educational program to physicians and adjunctive health care providers to advance patient care. Methods: This paper is based on a webcam presentation with roundtable discussion by several notable experts in their field. Results: A range of topical medications, injectable products, chemical peels, and energy‐based devices are available for treating acne vulgaris. In most instances, these are compatible with rejuvenation procedures in the aesthetic patient. Conclusion: The growth of social media is raising awareness of aesthetic procedures and appears to be increasing the number of patients seeking aesthetic treatment. Educating patients about the importance of treating acne vulgaris can improve overall treatment outcomes. In most instances, the presence of acne is not a barrier to aesthetic care. [ABSTRACT FROM AUTHOR]

Background: The Hispanic/Latin American population is the fastest growing non‐Caucasian group in the United States. Within this group, demand for aesthetic procedures is on the rise. High ethnic variability among these patients influences treatment approaches and patient priorities. Understanding these ethnic differences is central to providing optimal care. Aims: To discuss similarities and differences in anatomy and treatment preferences of Hispanic/Latin American patients both within the United States and internationally and explore how these differences may influence or inform aesthetic practices. Patients/Methods: In support of clinicians who wish to serve a diverse patient population, a 6‐part, international roundtable series focused on diversity in aesthetics was conducted from August 24, 2021 to May 16, 2022. In this roundtable, held in Medellin, Columbia, expert clinicians from across Latin America and the United States were invited to contribute and share best practices. Results: The results of the second roundtable in the series, the Latin American Patient, are described here. A special emphasis is placed on procedures that address the most commonly encountered concerns in these patients. Conclusions: Hispanic and Latino patients represent a broad demographic with unique anatomical features, aesthetic preferences, and treatment priorities. Clinicians should consider these differences when treating this patient population. [ABSTRACT FROM AUTHOR]

Background: Submental fullness (SMF) is a common cosmetic concern that can have negative impact on one's self‐esteem. ATX‐101 has shown promise as a minimally invasive treatment for SMF correction in clinical trials. Aims: To assess the safety and efficacy of ATX‐101 for SMF correction. Patients/Methods: This was a retrospective review of 90 patients from two aesthetic practices who received ATX‐101 injections for SMF (January 2016‐August 2017). There were no exclusion criteria. Initial SMF severity was assigned using standardized photographs and a validated 5‐point scale. Eighty one patients subsequently answered questionnaires regarding improvement, satisfaction, and adverse effects. Degree of SMF correction was also evaluated by the investigator and a blinded reviewer. Results: Eighty one patients (mean initial submental fullness severity 1.6) received a mean of 1.84 ATX‐101 treatment sessions using a median of 2.0 vials per treatment (mean 3.02, range 1‐9). Mean Physician Global Aesthetic Improvement Scale scores were 2.73 and 2.25, after the first and second treatments, respectively (P =.04). Mean Subject Goal Aesthetic Improvement Scale scores were 2.7 and 2.25 after the first and second treatments, respectively (P =.01). Sixty‐seven percentage of patients were "somewhat" or "very" satisfied. Adverse events were transient and limited to the treatment area. Conclusion: Patients achieved progressive improvement in SMF after the 1st and 2nd treatments, as judged by patients themselves, investigators, and blinded evaluators. These results of SMF correction suggest that significant benefit can be obtained with proper dosing at the initial visit. These data support the efficacy and safety profile of ATX‐101 use for SMF correction. [ABSTRACT FROM AUTHOR]

The desire for a more youthful appearance is that for which men and women often present for consideration of aesthetic interventions. For the female patient who is contemplating facial cosmetic enhancement, a true myriad of possible treatments exist. These options include neuromodulators, light‐based therapies, and soft tissue fillers, and are often touted as restoring a more "youthful" appearance to an otherwise aged‐appearing face. Perhaps it is not only youth that is being restored, but femininity, which in turn is appraised as being more beautiful. [ABSTRACT FROM AUTHOR]

BACKGROUND. The demand for minimally invasive aesthetic procedures has driven requests by physicians for guidance on their use in Asian patients, who have unique cultural preferences, social trends, and anatomy. However, few guidelines exist, particularly on combination treatment strategies for different facial shapes or indications such as the modification of face shapes to the "oval ideal."Physicians must, therefore, apply Caucasian patient-optimized guidelines to their Asian patients. METHODS. Eleven specialists developed a consensus on the use of botulinum toxin A (BoNT-A), calcium hydroxylapatite (CaHA) and hyaluronic acid (HA) fillers, and microfocused ultrasound with visualization (MFU-V) devices in Asian patients on upper-, middle-, and lower-face indications, including strategies to modify different facial shapes to the oval shape. Approval from 70 to 90 percent of all participants led to moderate consensus, while 90 percent agreement denoted a strong consensus. RESULTS. For early intervention/enhancement and restoration, most combination strategies are similar between Asian and Caucasian patients. Compared to Caucasian patients, however, beautification is a more common focus in Asian patients. The "ideal" oval facial shape can be created using different interventions depending on the patient's baseline characteristics. CONCLUSIONS. Although treatments and treatment sequences for early intervention/enhancement and restoration for beautification in Asian patients are similar to those in Caucasian patients, different treatment strategies may be required. [ABSTRACT FROM AUTHOR]

Microfocused ultrasound with visualization (MFU-V) is an advanced, non-invasive cosmetic procedure widely used in skin lifting and tightening. We performed a systematic review and meta-analysis to evaluate the aesthetic effectiveness, patients' satisfaction, skin quality, and safety profile of MFU-V treatment. A comprehensive search of 5 bibliographic databases up to 2023 was conducted. Pooled effect estimates using random effects models and corresponding 95% confidence intervals (95% CI) were calculated. Out of 4,019 references, 42 studies were included. Meta-analysis showed 89% of patients (95% CI: 81- 94%; I2: 63%, n=411) demonstrated some degree of global aesthetic improvement, as assessed by investigators. Similarly, 84% of patients (95% CI: 73- 91%; I2: 64%, n=312) reported improvement following treatment. Satisfaction of any level was reported by 84% of patients (95% CI: 61- 94%; I²: 52%, n=326), and 62% (95% CI: 37- 82%; I²: 3%, n=172) when 'neutral' as a response was provided for the patients. Skin quality (e.g., wrinkles, texture) also improved. Patients reported a pooled mean pain score of 4.85 (95% CI: 4.35, 5.35; I2: 97%, n=785), indicating moderate pain. Common adverse events included erythema, edema, swelling, bruising, and tenderness, all of which were generally mild to moderate in severity. Overall, our analysis demonstrated a notable increase in global aesthetic improvement and patients' satisfaction following MFU-V treatment, accompanied by moderate pain and a generally favorable safety profile. However, the potential misclassification of neutral responses as positive could result in an overestimation of the treatment's efficacy. These findings highlight the need for well-designed trials to further explore MFU-V's clinical applications., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Aesthetic Society.)

We evaluated real-life experiences of a topical neuro-peptide serum containing 2% acetyl hexapeptide-8, 2% dipeptide diaminobutyroyl, 5% polyhydroxy acids (PHA), 5% niacinamide, and 1% laminaria extract (topical neuro-peptide serum [TNP-serum]). The TNP-serum works synergistically by stimulating 9 key skin biomarkers to reduce wrinkles and produce a skin-brightening effect. Here, we highlight the real-life experiences of 5 dermatologists and 2 surgeons, using an integrated skincare regimen consisting of botulinum toxin type-A (BTX-A) injection in conjunction with twice daily TNP-serum. Real-world cases provide evidence for combination treatments that may be used in cosmetic dermatology to improve patient outcomes and satisfaction. TNP-serum appears to complement BTX-A injections to improve radiance, reduce fine lines, and reduce wrinkles in diverse patients. Incorporating TNP-serum into integrated skincare regimens may offer an additive effect to BTX-A injections and, ultimately, optimize patient results. J Drugs Dermatol. 2024;23:11(Suppl 2):s3-14.

Background: Facial aging is a complex interplay of extrinsic and intrinsic factors leading to progressive changes in the skin, subcutaneous tissue, and bone. Clinical experience suggests that early aesthetic intervention may slow the signs of aging, but treatment in the absence of symptoms or with minimal signs of aging has not yet been properly addressed., Objectives: To provide treatment recommendations for primary prevention and early intervention in individuals with no or minimal signs of aging., Methods: Fourteen specialists in aesthetic medicine convened over a full-day meeting under the guidance of a certified moderator., Results: Tailored treatment recommendations have been provided for prevention and early intervention of fine wrinkles, static lines and folds, irregular pigmentation, laxity, and subcutaneous volume loss by protecting the epidermis, stimulating neocollagenesis, reducing hyperkinetic musculature, and reinforcing supporting structures., Conclusion: Preventive measures and early therapeutic interventions that may alter the course of facial aging were defined. Further studies are needed to support these recommendations with the best possible evidence.

J Drugs Dermatol. 2017;16(9):846-854.