Aesthetic Surgery

Background: In facial aesthetics, grading systems are useful tools for planning aesthetic procedures. One key component of rejuvenation-the anterior neck-has been relatively overlooked. In the 1980s, criteria were established for the appearance of a youthful neck. Considering the significant contribution of the anterior neck to the aesthetics of the lower face, updated and more extensive clinical evaluation tools are critical to successful execution and measurement of rejuvenation. A validated assessment scale has yet to be created for platysmal banding, one component of the anterior neck that significantly contributes to the aesthetics. Objectives: The purpose of this study was to establish a validated platysmal banding scale for clinical application. Methods: Three-dimensional standardized photographs from over 100 volunteer patients of various ages and ethnicities were analyzed to develop a fivepoint scale for platysmal banding. The scale was validated by a group of academic and nonacademic attending plastic surgeons as well as senior level plastic surgery residents then analyzed through a two stage process to ensure both interrater and intrarater validity. Results: We measured the Intraclass Correlation Coefficients (ICC) for the interrater reliability. ICCs ranged from moderate to excellent agreement. Cronbach's alpha, which represents intrarater reliability, was also calculated for the same sample with all results being good to excellent. Conclusions: This study established a validated scale to assess the degree of platysmal banding in the female neck. This grading system has potential application in the preprocedure planning for patients considering face and neck rejuvenation to address platysmal banding.

Gynecomastia is a benign enlargement of the male breast. In gynecomastia surgery, which is highly successful in improving this aesthetic problem, the primary concerns are to avoid contour irregularities, infection, hematoma, seroma, skin injuries, and extensive scarring. The aim of gynecomastia surgery is to restore a normal chest contour with minimal signs of breast surgery. Suction drains traditionally have been placed after gynecomastia surgery. They are thought to aid the removal of undesirable postoperative matter and minimize tissue dead space. These drains are costly not only in economic terms but also in terms of recordkeeping, nursing time, and postoperative care. Patients often report discomfort associated with drains, and drain sites can leave conspicuous scars and may represent potential sources of tract formation or infection. Outpatient management of drains can present a source of concern for patients who have shorter hospital stays and therefore must care for the drain site at home. The effectiveness of surgical drains in reducing postoperative hematomas also has been questioned in other breast-related surgeries. In this study, we retrospectively analyzed the results of surgeries performed for different grades of gynecomastia without drains to determine whether this practice had any adverse effect on patient outcomes. We retrospectively analyzed the charts of 138 consecutive male patients who underwent bilateral gynecomastia 526598A ESXXX10.

This case report explores the application of photostimulated fat grafting from laser-assisted liposuction for penile girth augmentation. The patient, a 25-year-old male with normal penile length, sought the procedure due to dissatisfaction with his girth. The procedure involved the use of a 1210-nm diode laser (Lipo One STEP HD, DMC Group, Brazil) to stimulate adipocytes, which were then aspirated and grafted onto the penis. The patient reported satisfaction with the results, with no adverse events noted. This report contributes to the scientific literature by detailing the potential of photostimulated laser-assisted liposuction in penile girth augmentation, highlighting its efficacy and safety. The patient’s perspective underscores an improvement in self-esteem and quality of life post-procedure. This technique offers a novel approach in aesthetic surgery, demonstrating promising results in various applications.

Background: The size and weight of hypertrophied breast can cause both physical and psychological problems. Although the majority of these problems can be solved with breast reduction surgery, the particular problem of development of brassiere strap grooves on the shoulders due to the weight of the breasts cannot be corrected with this method. Objectives: Breast reduction surgery focuses only on the increased dimensions of breasts: fullness of the thoracic wall lateral to the breasts, as well as the appearance of brassiere strap grooves, need to be taken into consideration to obtain a better upper body image. Therefore, we present a series of 10 female patients who were treated with fat injections for the correction of brassiere strap grooves. Methods: Reduction mammaplasty and fat injections into the brassiere strap grooves were performed during the same session. Results: Dramatic changes are obtained with judicious placement of fat into the bra strap grooves. Conclusions: A more aesthetic and harmonious look can be obtained with using these combined aesthetic procedures in appropriately selected patients.

Background VYC-12L is a hyaluronic acid filler to improve skin quality. A prospective study showed safety and effectiveness of VYC-12L for improving cheek skin smoothness and fine lines. Objectives To report participant-reported outcomes, subgroup analyses, and physician experience from the prospective study. Methods Adults with moderate to severe Allergan Cheek Skin Smoothness (ACSS) scale scores were randomized 2:1 to VYC-12L or control (no treatment with optional treatment). Participant assessments included FACE-Q Satisfaction With Skin, FACE-Q Appraisal of Lines, natural look and feel, the Global Aesthetic Improvement Scale (GAIS), and safety. Subgroup analyses examined ACSS responder rate (≥1-grade improvement from baseline to 1 month). Results FACE-Q Satisfaction With Skin overall mean scores improved from baseline to 1 month posttreatment by 32.0 and 1.4 in the VYC-12L and control groups, respectively. FACE-Q Appraisal of Lines overall mean scores improved from baseline to 1 ...

Our current understanding of lymphatic pathways in the face and cheek is based on dye studies reported over a century ago. The graphic representation of lymphatic drainage of the head and neck region arises from drawn maps, with supporting evidence from oncologic sentinel lymph node data. 2 Experimental models have mapped periorbital lymphatic pathways in primates but not humans. A single patient study proposed a theoretical reversal of lymphatic flow toward the midline after facelift. 5 Also, it has commonly been assumed that deeper facelift dissection causes greater and more prolonged swelling, but that assumption has never been scientifically studied. Identifying the patterns of lymphatic drainage from the cheek before and after rhytidectomy would help to characterize the anatomic structural modifications caused by differing rhytidectomy techniques. Lymphoscintigraphy, a nuclear imaging technique that allows dynamic visualization and mapping of draining lymphatic channels and lymph nodes utilizing a radiolabeled colloid (most commonly 99m Tc-sulfur colloid in the United States), was utilized in the present study to examine these patterns and to assess-and potentially differentiate between-the lymphatic disruption caused by common facelift techniques that vary in depth of dissection.

With socioeconomic development and changing aesthetic paradigms, people are increasingly attentive to facial beauty. The proportions, harmony, and balance of facial features have become aesthetic focal points. Among the facial features, the nose and chin (mentum) are particularly critical: the nose largely determines the three-dimensional impression of the face, while the chin influences the lower-face contour and overall proportions. Modifying or enhancing these regions can visually elevate facial aesthetics and significantly impact individual psychological confidence.

Background: While validated scales must be created in order to systemically evaluate patients and quantify outcomes of aesthetic hand treatments, scales currently available are limited to the analysis of volume loss alone. The purpose of this study was to develop 3 validated scales for the assessment of dorsal hand aging that also take into consideration wrinkling and pigmentation. Methods: Fifty (50) healthy volunteers (40 females and 10 males) with Fitzpatrick skin types I-IV were recruited, and standard photographs of their left and right dorsal hands were taken with a Nikon D7100 (Nikon; Minato, Tokyo, Japan) camera. Using 25 randomized photographs, 11 plastic surgery physicians (3 chief residents, 6 senior residents, and 2 aesthetic surgery fellows) were trained on the 3 scales under investigation as well as the already-validated Merz Hand Grading Scale (MHGS). The evaluators then viewed the remaining 75 photographs independently and assigned a grade for each of the 4 scales to each photograph. Inter-rater variability was calculated for each scale. The Kappa score for the MHGS was 0.25, indicating fair agreement; 0.40 for wrinkle scale, indicating fair agreement; and 0.48 and 0.46 for the pigmentation density and intensity scales, respectively, indicating moderate agreement (P < 0.001). The results show that after receiving training, the inter-rater agreement for the 3 scales under investigation was similar or slightly higher than that for the MHGS. These 3 photographic classification systems can be used consistently and reliably to characterize multiple signs of dorsal hand aging.

Background Follicular unit extraction (FUE) hair transplantation subjects are excellent candidates to assess wound dressings. The wound surface area is large and adequately delineated to allow randomization, while in-patient split scalp designs allow patients to serve as their own controls. Objectives This randomized, single-blinded, split-scalp comparison trial compares a novel, film-forming silicone gel—Stratamed (SM; Stratpharma AG, Basel, Switzerland)—to Bacitracin (Bac; McKesson Medical-Surgical Inc., Richmond, VA) in subjects undergoing FUE. Methods Twenty subjects were randomized to receive SM and Bac on alternating sides of the scalp. Primary outcome measures included blinded clinician assessments of edema, erythema, crusting, healing response and outcome preference. Secondary measures included subject-reported assessments of pain and pruritis as well as FaceQ scores taken at post-FUE days two through six. Results Twenty subjects were enrolled. Nineteen completed the trial. ...

Background While validated scales must be created in order to systemically evaluate patients and quantify outcomes of aesthetic hand treatments, scales currently available are limited to the analysis of volume loss alone. Objectives The purpose of this study was to develop 3 validated scales for the assessment of dorsal hand aging that also take into consideration wrinkling and pigmentation. Methods Fifty (50) healthy volunteers (40 females and 10 males) with Fitzpatrick skin types I-IV were recruited, and standard photographs of their left and right dorsal hands were taken with a Nikon D7100 (Nikon; Minato, Tokyo, Japan) camera. Using 25 randomized photographs, 11 plastic surgery physicians (3 chief residents, 6 senior residents, and 2 aesthetic surgery fellows) were trained on the 3 scales under investigation as well as the already-validated Merz Hand Grading Scale (MHGS). The evaluators then viewed the remaining 75 photographs independently and assigned a grade for each of the 4 ...

Background Traditional invasive suture suspension techniques have proven efficacy and durability. A previously described percutaneous placement of a neck suspension suture with light guidance has transformed this into a minimally invasive technique. This novel technique provides a major advance for minimally invasive neck rejuvenation. Objectives The authors sought to describe their experience with light-guided percutaneous neck rejuvenation over the past 4.5 years, including technique, patient selection, safety profile, and expected outcomes. Methods Data were retrospectively reviewed for all patients who underwent the procedure with 5 surgeons across 4 aesthetic plastic surgery practices from January 2018 through May 2022. Inclusion criteria were mild to moderate neck laxity, prominent anterior platysma bands, and desire to improve neck contour. Patients undergoing concurrent skin incision &gt;5 mm (ie, open rhytidectomy or platysmaplasty) were excluded. Results A total of 391 pat...

Background Laxity of the submental area is a common cosmetic complaint of the aging population. Objectives The aim of this study was to determine the safety and effectiveness of a temperature-controlled, minimally invasive percutaneous monopolar radiofrequency device to improve dermal laxity and achieve lift. Methods A total of 72 subjects (35-65 years old) with mild to moderate skin laxity in the submental area were included in this single-center prospective study. All subjects received 1 treatment at baseline with an average subdermal temperature of 63°C. The primary endpoint was the proportion of subjects with at least a 20-mm2 decrease in surface area at Day 90 based on 3-dimensional photography. Secondary endpoints included skin elasticity measured by Cutometer, assessment by a blinded physician panel from 2-dimensional photographs, and physician- and subject-reported outcomes. Results At Day 90, 72.1% (95% CI: 62.2%-84.0%; P &lt; 0.001) of subjects achieved at least a 20-mm2 l...

Seromas are a common complication in plastic surgery. In this article, the authors describe their approach to the prevention and treatment of seromas and include a discussion of the evolution of their techniques. They provide specific technical details for many body contouring operations, including abdominoplasty, belt lipectomy, brachioplasty, and thighplasty. Many of the authors’ techniques question the traditional dictums of plastic surgery, and they hope to encourage others to consider novel techniques for the treatment and prevention of seromas. Level of Evidence: 4

Suction-assisted lipectomy (or “liposuction”) is a fundamental technique for all plastic surgeons, and like many procedures in aesthetic surgery, its applications are continuing to evolve. With the rapid introduction of new technologies, many plastic surgeons are left with questions about how these new devices work, what results to expect, and how to best apply these technologies in their practice. We recognized that there is a need for unbiased recommendations to guide surgeons on how to approach current liposuction devices (as well as their adjuncts) and how to use them effectively for their patients. Using available literature and personal experience, we answer the most common questions that we hear from our plastic surgery colleagues.

Background: Classical fat grafting techniques are relatively difficult to learn and sometimes complications (fat indurations and irregularities) arise as well as unpredictable reabsorption of the transplanted fat. We present an innovative technique of fat grafting which proved to be very useful in combination with orthognatic surgery where maximal reliability and minimal complications are very important. Objectives: The aim of this study was to show how micro fractured fat transplantation obtained with a new closed disposable device (Li-pogems®) applied in combination with orthognatic surgery can obtain very nice surgical outcomes with no complications and minimal postoperative swelling. Methods: 120 patients undergoing double jaw orthognatic surgery were treated at the end of orthognatic procedure with Lipogems® micro fat grafting technique. Follow up was at 1 day, 1 week, 1, 6 and 12 months. The charts of the patients were reviewed and all the patients re-examined at 12 months by the senior surgeon (M.R.) who scored the quality of results of these series based on his expert opinion. Also a very simple subjective scoring of the patient's satisfaction of this series was proposed and compared to the past. Concerning the comparison to the past a series of 903 patients from 2001 to 2010 was considered with very similar distribution of main deformity and in which the fat grafting technique was progressively modified and improved. Only the patient subjective assessment of the result is available for these past series and the exact placement and quantity of fat grafting is not always available making meaningful objective comparison difficult. Results: The management of the soft tissue volumes with lipogems micro fat grafting technique allowed satisfactory results with no complications at 12 months follow-up in all 120 patients. Both facial morphology and skin texture were enhanced short and long term by the adjunct of lipogems grafting. More notably, comparing with our previous experience in a similar and larger series of patients using different lipofilling techniques, the immediate postoperative results (1 day and 1 week) showed much less swelling and pain than usual and longer term follow up (1, 6 and 12 months) showed minimal reabsorption and no irregularities or induration. This early reduction in postoperative swelling and pain, although not objectively quantified in this study, was an interesting and unexpected finding which was noted by all caring doctors and nurses. The percentage of "very satisfied" patients was higher in this series compared to the past although the significance of this data as related to the new fat graft procedure is unclear. Conclusion: Adding transplantation of micro fractured adipose tissue at the end of orthognatic procedure using lipogems technique reduce immediate postoperative pain and swelling and improve final aesthetic outcomes and patient satisfaction with no complications. The surgical technique is much simpler than classical one as micro fat grafts homogeneously fill the subcutaneous tissue avoiding irregularities. The authors recommends lipogems fat graft technique as a routine adjunct to orthognatic surgery.

Purpose: To evaluate the effect of periocular filler injection on the incidence of cerebral venous thrombosis (CVT). Case Report: A 41-year-old woman without a prior medical history experienced a severe headache and subsequent seizures following an eye filler injection. Diagnosis of CVT was confirmed through brain magnetic resonance venography (MRV), revealing thrombosis in the left transverse and upper sagittal sinuses. The patient was treated with intravenous heparin and oral warfarin, leading to improvement and discharge in good condition after 10 days of hospitalization. Conclusion: This case underscores the potential risk of CVT following periocular filler injections, emphasizing the need for awareness and preventive measures among medical professionals.

The results of experimental studies indicate that grafting of autologous adipose tissue may induce tumorigenesis at the recipient site, but clinical results do not support a carcinogenic effect of fat grafting to the breast. Objectives: The authors assessed cancer risk following transplantation of autologous fat into murine mammary tissue. Methods: In this animal study, mammary tissues from 54 breasts of 9 female rats were either grafted with autologous subcutaneous fat, grafted with autologous omental fat, or unmanipulated. Tissues were harvested and processed for histologic and immunohistochemical analyses, and the mRNA expression levels of specific genes were determined. Results: No atypia or changes in lobular structures were observed in lipofilled breasts compared with controls. The numbers of ductal cell layers and terminal ductal units were similar for lipofilled and control breasts. Macrophage concentrations also were similar for the 3 groups. The localization and magnitude of plasminogen activator inhibitor 1 were similar for lipofilled and unmanipulated breast tissue. The percentages of cells expressing Ki67 or estrogen receptor (ER) and the ER/Ki67 balance were similar for the 3 groups. Gene expression was not altered in lipofilled breasts, compared with controls. Conclusions: No theoretical risk of cancer was detected in the microenvironment of the lipofilled rat breast.

Fractional radiofrequency (RF) microneedling is commonly used for
skin and body rejuvenation by inducing controlled thermal micro-injuries
that stimulate collagen and elastin production. However, conventional
techniques often cause discomfort, especially when targeting deeper
tissues. This case report evaluates the histological effects of the Exion
Fractional RF device using its Extended Mode, which creates a thermal
gradient reaching deeper layers without full needle penetration. A 40-yearold male subject (BMI 22.9) received a single-pass treatment to the face
and abdomen, with insulated microneedles delivering monopolar RF
energy at varying depths (1.0–4.0 mm) and intensities (60% and 100%).
Biopsies were taken immediately post-treatment, and on Days 7 and
30. Histological analysis using H&E and Masson's trichrome staining
revealed a consistent 4-mm thermal gradient in abdominal tissue, with
evidence of collagen coagulation and remodeling extending beyond needle
depth, while preserving the integrity of the epidermis. By Day 30, early
neocollagenesis and signs of adipocyte apoptosis, including membrane
disruption and fibrotic changes, were noted. These findings suggest that
the Extended Mode enables effective deep tissue remodeling and adipose
targeting while minimizing epidermal disruption.

The Platelet Rich Plasma (PRP) has become a leading candidate of cosmetic industry as a revolution treatment in skin rejuvenation, anti-aging therapies, and hair restoration. In light of this, the business potential of PRP in the cosmetic industry is explored in this thesis from a market trend, consumer perception and strategic opportunities perspective. Considering it is minimal invasive procedure based on autologous growth factors it became very popular since it is efficient and natural way of enhancing aesthetics. The research looks at PRP treatments becoming of greater need to fill this increasing demand as a result of people preferring non-surgical cosmetic procedures and regenerative medicine advances. It also studies consumers attitude to PRP such as attitude in PRP factor, accept, trust and willing to pay for such treatment. Moreover, the study highlights important market drivers, market challenges and opportunities to new and existing businesses introducing or targeting PRP market. The research presents strategic recommendations for integrators, by reviewing industry reports, consumer surveys and expert insights while using it as a basis to provide insights for stakeholders such as dermatologists, aesthetic clinics as well as investors. Results indicate that PRP's market growth is due to increasing disposable incomes, technological developments, and moving toward personalized beauty solutions. However, regulatory considerations and the challenges of establishing standards are barriers to adoption of it. This research provides useful information about the commercial viability of PRP, which helps businesses in better positioning themselves for profitable business in a sustainable manner.

The use of Botox within the sports community has evolved well beyond its original therapeutic indications, becoming part of a broader movement toward aesthetic optimization and the harmonization of body image. This trend, amplified by social media-particularly Instagramreflects multifaceted motivations, including the pursuit of beauty, the minimization of visible signs of intense training, the correction of cutaneous changes associated with anabolic steroid use, and the maintenance of a carefully curated public image. Athletes, whether elite professionals or influential amateurs, frequently share personal or instructional training videos, where attributes such as youthfulness, vitality, and physical attractiveness play a decisive role in perceived appeal and credibility. In this context, the unique physiological and metabolic characteristics of athletes, combined with the demands of constant media exposure, require specific clinical considerations and tailored aesthetic approaches. The present article explores the clinical, psychosocial, regulatory, and ethical dimensions of this emerging practice, with particular attention to its implications in the era of performance-driven public image management.

R Facial adipo-structuring has emerged as an effective technique for three-dimensional facial volume restoration, combining both structural and regenerative effects. This study aims to present the clinical outcomes observed in 103 patients treated with facial adipostructuring between 2018 and 2024, evaluating its efficacy, safety, and patient satisfaction. An observational, descriptive, and retrospective case series was conducted. Patients (both sexes, aged 16 to 82 years) were treated in areas such as the malar region, jawline, chin, nose, lips, and submental fat. Clinical follow-up included tools such as the Visual Analog Scale (VAS), the Global Aesthetic Improvement Scale (GAIS), and the Common Treatment Response Diary (CTRD). Results showed a predominance of female patients, although 11.65% were male-reflecting the growing interest among men in minimally invasive procedures. Of all patients, 50.4% were aged 40 to 59 years, 25.2% were over 60, and 26.2% were under 39, indicating both corrective and preventive use. A total of 53.4% received 2 to 3 sessions, while 16.5% required four or more. In terms of tolerance, 97.1% reported no or mild pain, with no cases of severe pain or infection. Side effects were mild and transient, including erythema (100%) and bruising (64.08%). Significant aesthetic improvement (GAIS scores 1 and 2) was observed in 84.5% of cases, and 76.7% reported improvement in skin quality. Facial adipo-structuring proved to be a safe, effective, and highly satisfactory technique for volumetric restoration and facial rejuvenation, with minimal discomfort and transient adverse effects.

R Facial adipo-structuring has emerged as an effective technique for three-dimensional facial volume restoration, combining both structural and regenerative effects. This study aims to present the clinical outcomes observed in 103 patients treated with facial adipostructuring between 2018 and 2024, evaluating its efficacy, safety, and patient satisfaction. An observational, descriptive, and retrospective case series was conducted. Patients (both sexes, aged 16 to 82 years) were treated in areas such as the malar region, jawline, chin, nose, lips, and submental fat. Clinical follow-up included tools such as the Visual Analog Scale (VAS), the Global Aesthetic Improvement Scale (GAIS), and the Common Treatment Response Diary (CTRD). Results showed a predominance of female patients, although 11.65% were male-reflecting the growing interest among men in minimally invasive procedures. Of all patients, 50.4% were aged 40 to 59 years, 25.2% were over 60, and 26.2% were under 39, indicating both corrective and preventive use. A total of 53.4% received 2 to 3 sessions, while 16.5% required four or more. In terms of tolerance, 97.1% reported no or mild pain, with no cases of severe pain or infection. Side effects were mild and transient, including erythema (100%) and bruising (64.08%). Significant aesthetic improvement (GAIS scores 1 and 2) was observed in 84.5% of cases, and 76.7% reported improvement in skin quality. Facial adipo-structuring proved to be a safe, effective, and highly satisfactory technique for volumetric restoration and facial rejuvenation, with minimal discomfort and transient adverse effects.

R Facial adipo-structuring has emerged as an effective technique for three-dimensional facial volume restoration, combining both structural and regenerative effects. This study aims to present the clinical outcomes observed in 103 patients treated with facial adipostructuring between 2018 and 2024, evaluating its efficacy, safety, and patient satisfaction. An observational, descriptive, and retrospective case series was conducted. Patients (both sexes, aged 16 to 82 years) were treated in areas such as the malar region, jawline, chin, nose, lips, and submental fat. Clinical follow-up included tools such as the Visual Analog Scale (VAS), the Global Aesthetic Improvement Scale (GAIS), and the Common Treatment Response Diary (CTRD). Results showed a predominance of female patients, although 11.65% were male-reflecting the growing interest among men in minimally invasive procedures. Of all patients, 50.4% were aged 40 to 59 years, 25.2% were over 60, and 26.2% were under 39, indicating both corrective and preventive use. A total of 53.4% received 2 to 3 sessions, while 16.5% required four or more. In terms of tolerance, 97.1% reported no or mild pain, with no cases of severe pain or infection. Side effects were mild and transient, including erythema (100%) and bruising (64.08%). Significant aesthetic improvement (GAIS scores 1 and 2) was observed in 84.5% of cases, and 76.7% reported improvement in skin quality. Facial adipo-structuring proved to be a safe, effective, and highly satisfactory technique for volumetric restoration and facial rejuvenation, with minimal discomfort and transient adverse effects.

DaxibotulinumtoxinA is a next-generation botulinum toxin type A formulation designed for the temporary improvement of moderate-to-severe glabellar lines through neuromuscular chemodenervation. Derived from the Clostridium botulinum Hall strain, this neurotoxin employs a unique synthetic peptide stabilizer (RTP004) that enhances molecular binding, reduces diffusion, and extends clinical efficacy compared to existing formulations. This review provides a comprehensive examination of daxibotulinumtoxinA, including its microbiological origin, molecular pharmacology, pharmacokinetics, and therapeutic advantages. FDA approval currently limits its use to glabellar line correction; however, ongoing studies explore additional indications. Adverse effects are generally localized and mild but can include systemic neuromuscular complications if diffusion occurs. Contraindications include hypersensitivity and active infection at injection sites, while caution is warranted in neuromuscular disorders, pregnancy, and lactation. Clinical monitoring at two weeks and a dosing interval of approximately six months optimize outcomes and reduce injection frequency. Successful implementation requires interprofessional collaboration to ensure accurate dosing, injection technique, patient education, and prompt recognition of adverse events. This work synthesizes current evidence to guide advanced clinical practice and future research in botulinum neurotoxin pharmacotherapy.

Elastin peptide are emerging as a promising class of bioactive compounds in nutricosmetic research.

The fish bulbus arteriosus, a specialized elastic organ responsible for hemodynamic buffering, represents a unique and underexplored source of elastin-rich connective tissue.

Through targeted enzymatic hydrolysis, elastin proteins from this tissue can be converted into low-molecular-weight peptides (0.5-2 kDa), which exhibit superior intestinal absorption via PepT1 transporters.

These peptides retain elastin-specific cross-linking amino acids, desmosine and isodesmosine, conferring high biochemical homology with human dermal, vascular, and pulmonary elastic fibers.

Mechanistically, oral elastin peptides provide structural substrates for fibroblast-mediated elastic fiber regeneration, support the collagen-elastin dual-network for dermal tensile strength and resilience, and exert anti-oxidative and anti-proteolytic activities that protect the extracellular matrix (ECM) from premature degradation.

Furthermore, their vascular homology suggests potential benefits for arterial compliance and systemic elasticity maintenance.

When combined with collagen peptides, elastin peptides enable synergistic remodeling of the ECM, addressing both tensile and elastic components of skin aging.

Collectively, elastin peptides derived from fish bulbus arteriosus offer a novel precision-nutrition strategy for mitigating fine lines, restoring dermal elasticity, and delaying structural skin aging, while also contributing to vascular and systemic tissue health.

The development of high-frequency devices and transducers in recent years has enabled the growth of the use of dermatologic ultrasound. Real-time monitoring of the anatomy of the face during the application of aesthetic injectables potentially prevents complications such as vascular occlusions. Injecting physicians starting out in the practice of ultrasoundguided injections are commonly faced with practical questions about its use. In this article, based on the experience with ultrasound-guided filler injections of 2 large clinical centers in 2 countries, the authors summarize the steps involved when setting out to use ultrasound to guide injectable aesthetic procedures, such as fillers and biostimulators. First, the authors discuss factors that guide the choice of equipment and ultrasound transducers to perform the procedures. Next, a detailed discussion on practical issues related to the procedure is provided. The authors then consider the positioning of operators and equipment in the treatment field. The authors conclude by suggesting 2 possible techniques to guide injectable procedures: (1) scan before injecting or (2) scan while injecting. O desenvolvimento de aparelhos e transdutores de alta frequência nos últimos anos possibilitou o crescimento do uso do ultrassom dermatológico. O monitoramento em tempo real da anatomia do rosto durante a aplicação de injetáveis estéticos previne potencialmente complicações, como oclusões vasculares. Os médicos que iniciam a prática de injeções orientadas por ultrassom geralmente se deparam com questões práticas sobre a respectiva utilização. Neste artigo, com base na experiência com injeções de preenchimento orientadas por ultrassom de dois importantes centros clínicos em dois países, os autores resumem as etapas envolvidas ao iniciar o uso do ultrassom para orientar procedimentos estéticos injetáveis, como preenchimentos e bioestimuladores. Inicialmente, os autores abordam fatores que orientam a escolha de equipamentos e transdutores de ultrassom para a realização dos procedimentos. Em seguida, fazem uma

This literature review explores the psychological processes and emotional shifts associated with cosmetic injectable use, particularly botox and dermal fillers, among adults aged 18 to 50. The review synthesizes findings from peer-reviewed sources published through 2020 and examines emotional, cognitive, and behavioral patterns across three distinct timeframes: before the decision to undergo treatment, during the effect window (2 to 6 months), and after the effects begin to wear off. The evidence highlights common psychological motivators such as body dissatisfaction, social comparison, and identity reinforcement, while also revealing emotional volatility in the post-effect phase, including depressive symptoms, shame, or relief. Gender differences, age-related concerns, and repeat usage patterns are also addressed. Findings underscore the importance of pre-treatment screening and emotional support throughout the cosmetic intervention journey.

Background: The anatomy of the nose of different ethnic groups has been widely researched in order to facilitate a better understanding of the individual nose as a foundation for improving surgical outcomes. The only anatomical research of the lower lateral cartilages (LLCs) available to the surgeon working with an African patient is to extrapolate data from studies already published on African Americans. Objectives: The aim of this descriptive cadaveric study was to assess the normal anatomy of the LLCs in noses of Black South Africans and compare this to data from studies on noses from Caucasian, Asian, Korean, and African-American populations. Methods: Ninety lower lateral cartilages of 45 cadavers of Black South Africans who did not have previous surgery or trauma to the nose were dissected. The morphological shapes and 12 standard anatomical measurements were recorded. The results were analyzed and compared to data in the literature from studies on lower lateral cartilages of Caucasian, Asian, Korean, and African-American populations. Results: A statistically significant difference was found in terms of overall cartilage dimensions, distance from nasal rim, and morphological shapes, compared to all previously studied groups, including the African-American population. There were significant differences in cartilage dimensions between males and females. This translates to clinically significant data that is useful during reconstructive and aesthetic nasal surgery on patients with a Southern African background. Conclusions: This study sets norms for alar cartilages in Black Southern Africans.

Background Facial asymmetry is considered a reason for patient dissatisfaction with the outcome of rhinoplasty. Objectives The aim of this study was to evaluate the impact of facial asymmetry on patient postoperative satisfaction with crooked nose and to investigate the relationship between visual perception of asymmetry and anthropometric measurements. Methods In this retrospective study, 61 rhinoplasty patients with crooked noses were assessed. Utilizing frontal view photos, pre- and postoperative nasal deviation angles were calculated. The patients were divided into 2 groups based on the visual presence of facial asymmetry. Moreover, anthropometric characteristics of the face were evaluated utilizing facial soft tissue landmarks. Patient satisfaction with surgery outcomes, including both aesthetic and functional aspects, was assessed employing the Persian version of the Standardized Cosmesis and Health Nasal Outcomes Survey. Results Based on the observations, 19 (30.2%) and 44 (6...

Background: Plasma gel is a gelatinous substance made of proteins that have been gelled together and includes fibrin, which gives the formula more firmness and resistance than regular platelet-rich plasma. The aim of this work was to evaluate the safety and efficacy of autologous plasma gel injection in treatment of tear trough deformity. Methods: This study was carried out on 10 female patients presented with tear trough deformity without prior cosmetic therapy or performed any facial surgery. Female patients were received two sessions of autologous plasma gel injection at 2-week interval. Results: There was statistically significant improvement (decrease) in Tear Trough Rating Scale after intervention compared to before intervention (P=0.004). Regarding patient satisfaction after treatment, all patients showed various degree of satisfaction as follows: there was any patient very satisfied, 2 patients (20%) satisfied, 4 patients (40%) neutral, 3 patients (30%) dissatisfied, and 1 patient (10%) very dissatisfied. Conclusions: The present study showed that plasma gel was safe and effective in the treatment of Tear Trough Deformity. Plasma gel give significantly better outcome as regard global improvement, complications and patient satisfaction.

Background: Studies show the efficacy and safety of nasal reshaping with hyaluronic acid. However, there is little evidence on the clinical parameters modified to achieve an aesthetic improvement in the nasal profile. In aesthetic analysis, the nasolabial angle has often been used to evaluate the rotation of the nasal tip in non-surgical rhinoplasty, a parameter dependent on the position of the upper lip. The researchers declare no conflicts of interest.

Background: VYC-12L is a hyaluronic acid filler to improve skin quality. A prospective study showed safety and effectiveness of VYC-12L for improving cheek skin smoothness and fine lines. Objectives: To report participant-reported outcomes, subgroup analyses, and physician experience from the prospective study. Adults with moderate-to-severe Allergan Cheek Smoothness Scale (ACSS) scores were randomized 2:1 to VYC-12L or control (no-treatment with optional treatment). Participant assessments included FACE-Q Satisfaction with Skin, FACE-Q Appraisal of Lines, natural look and feel, Global Aesthetic Improvement Scale (GAIS), and safety. Subgroup analyses examined ACSS responder rate (≥ 1-grade improvement from baseline to 1-month).

Background: Hyaluronic acid (HA) soft tissue fillers are used to restore volume loss to the lips and perioral area. Objective: Evaluate the safety and effectiveness of the HA filler Juvéderm ® Volbella ® (VYC-15L) for lip enhancement in Chinese adults. In this multicenter, evaluator-blind study, subjects seeking lip enhancement were randomized 3:1 to VYC-15L or no-treatment control group (with optional treatment delayed by 3 months). Effectiveness endpoints included 1-point improvement on the 5-point Lip Fullness Scale (LFS) assessed by evaluating investigators (EIs) and subjects, and overall volume of lips and change in lip surface area measured from 3-dimensional images. Safety assessments included procedural pain, injection site reactions (ISRs), and adverse events (AEs). The modified intention-to-treat population included 163 subjects (median age, 34 years; 96.9% female). More VYC-15Ltreated subjects had a 1-point reduction in EI-reported LFS score at month 3 versus untreated controls (84.7% vs 0%; p < 0.0001), and 65% of the treated subjects self-reported a 1-point LFS improvement at month 3. Procedural pain during injection was mild. The most common ISRs were swelling, tenderness to touch, and firmness. One treatment-related serious AE (injection site compression arterial ischemia) resolved in 16 days. Conclusion: VYC-15L treatment was superior to no treatment at 3 months and was well tolerated by subjects. Clinical Trial Registration Number: NCT03519204.

Background: Infraorbital hollowing can be addressed with hyaluronic acid soft tissue fillers. A prospective, multicenter, evaluator-blinded, randomized, controlled study (NCT03418545) demonstrated the safety and effectiveness of Juvéderm Volbella XC (VYC-15L, Allergan Aesthetics, an AbbVie company, Irvine, CA) in adults seeking correction for infraorbital hollows. Objective: The objective of the current analysis was to examine patient-reported outcomes from the clinical study. Methods: Participants were randomly assigned 3:1 to the VYC-15L treatment group or the no-treatment control group. Outcome measurements included: evaluating investigator (EI)-and participant-assessed Global Aesthetic Improvement Scale (GAIS) scores, as well as participant responses to the FACE-Q Appraisal of Lower Eyelids, questions on treatment satisfaction, the extent to which patients were bothered by dark circles under their eyes, and willingness to recommend treatment to a friend. The modified intent-to-treat population included 135 participants (median age, 47 years; 91.9% female). At Month 3, the majority of VYC-15L-treated participants showed improvements in the EI-and participant-assessed GAIS. The mean change from baseline to Month 3 score (32.7% increase) showed statistically significant improvement (mean [standard deviation], 17.8 [19.8], P < .0001). At Months 3 and 12 posttreatment, most VYC-15L-treated participants reported feeling satisfied with treatment and not feeling moderately or very bothered by dark circles under their eyes, and would recommend treatment to a friend. The current analysis demonstrated the effectiveness of VYC-15L treatment to reduce infraorbital hollowing and to improve overall satisfaction based on validated patient-reported outcomes. Participant-assessed improvements aligned with EI-assessed outcomes and lasted for 1 year. Dr Fabi is a cosmetic dermatologist in private practice in San Diego, CA, USA. Dr Zoumalan is an oculoplastic surgeon in private practice in Beverly Hills, CA, USA. Dr Fagien is a cosmetic oculoplastic surgeon in private practice in Boca Raton, FL, USA. Dr Downie is a dermatologic surgeon in private practice in Montclair, NJ, USA. Dr Yoelin is an ophthalmologist in private practice in Newport Beach, CA, USA.

Background Infraorbital hollowing can be addressed with hyaluronic acid soft tissue fillers. A prospective, multicenter, evaluator-blinded, randomized, controlled study (NCT03418545) demonstrated the safety and effectiveness of Juvéderm Volbella XC (VYC-15L, Allergan Aesthetics, an AbbVie company, Irvine, CA) in adults seeking correction for infraorbital hollows. Objective The objective of the current analysis was to examine patient-reported outcomes from the clinical study. Methods Participants were randomly assigned 3:1 to the VYC-15L treatment group or the no-treatment control group. Outcome measurements included: evaluating investigator (EI)- and participant-assessed Global Aesthetic Improvement Scale (GAIS) scores, as well as participant responses to the FACE-Q Appraisal of Lower Eyelids, questions on treatment satisfaction, the extent to which patients were bothered by dark circles under their eyes, and willingness to recommend treatment to a friend. Results The modified inten...

Background VYC-12L is a hyaluronic acid filler to improve skin quality. A prospective study showed safety and effectiveness of VYC-12L for improving cheek skin smoothness and fine lines. Objectives To report participant-reported outcomes, subgroup analyses, and physician experience from the prospective study. Methods Adults with moderate to severe Allergan Cheek Skin Smoothness (ACSS) scale scores were randomized 2:1 to VYC-12L or control (no treatment with optional treatment). Participant assessments included FACE-Q Satisfaction With Skin, FACE-Q Appraisal of Lines, natural look and feel, the Global Aesthetic Improvement Scale (GAIS), and safety. Subgroup analyses examined ACSS responder rate (≥1-grade improvement from baseline to 1 month). Results FACE-Q Satisfaction With Skin overall mean scores improved from baseline to 1 month posttreatment by 32.0 and 1.4 in the VYC-12L and control groups, respectively. FACE-Q Appraisal of Lines overall mean scores improved from baseline to 1 ...

Background: Hyaluronic acid (HA) soft tissue fillers are used to restore volume loss to the lips and perioral area. Objective: Evaluate the safety and effectiveness of the HA filler Juvéderm ® Volbella ® (VYC-15L) for lip enhancement in Chinese adults. In this multicenter, evaluator-blind study, subjects seeking lip enhancement were randomized 3:1 to VYC-15L or no-treatment control group (with optional treatment delayed by 3 months). Effectiveness endpoints included 1-point improvement on the 5-point Lip Fullness Scale (LFS) assessed by evaluating investigators (EIs) and subjects, and overall volume of lips and change in lip surface area measured from 3-dimensional images. Safety assessments included procedural pain, injection site reactions (ISRs), and adverse events (AEs). The modified intention-to-treat population included 163 subjects (median age, 34 years; 96.9% female). More VYC-15Ltreated subjects had a 1-point reduction in EI-reported LFS score at month 3 versus untreated controls (84.7% vs 0%; p < 0.0001), and 65% of the treated subjects self-reported a 1-point LFS improvement at month 3. Procedural pain during injection was mild. The most common ISRs were swelling, tenderness to touch, and firmness. One treatment-related serious AE (injection site compression arterial ischemia) resolved in 16 days. Conclusion: VYC-15L treatment was superior to no treatment at 3 months and was well tolerated by subjects. Clinical Trial Registration Number: NCT03519204.

Background Rejuvenation of the under-eye area is a popular facial aesthetic treatment option. Objectives This study evaluated the safety and effectiveness of VYC-15L for the correction of moderate or severe infraorbital hollowing. Methods This was a randomized, controlled, single-blind study with a primary endpoint defined as the proportion of participants with ≥1-grade improvement at Month 3 assessed by an evaluating investigator employing the Allergan Infraorbital Hollow Scale. Three-dimensional imaging was conducted to assess infraorbital volume up to Month 12. Procedure pain and injection-site responses (ISRs) were documented, and safety was monitored throughout the study. Results At Month 3, the difference between treatment (83.1%) and control (15.6%) was 67.5% (95% CI = 52.9 to 82.0, P &lt; 0.0001). 3D imaging showed a mean volume increase from baseline of 0.733 mL (left) and 0.777 mL (right) at Month 12. Mean pain scores were ≤1.7 (scale of 0 to 10). Most ISRs with initial tr...