The Shifting Face of Aesthetic Care: A Systematic Survey of Independent Medical Spa Directorship and Practitioner Trends in Florida.

Background: The rapid proliferation of medical spas (med spas) in the United States has raised concerns over the continued shift of nonsurgical aesthetic treatments away from traditional core specialty integration and supervision, potentially affecting surgical treatment guidance and education of cosmetic surgery patients. The authors assessed trends in the growth of independent med spa facilities as well as practitioner supervision, licensing, and specialization in the state of Florida.

Methods: The authors performed a comprehensive, statewide survey of all independent med spas in Florida by municipality using online business search engines.

Additive Orthodiagonal Rhytidoplasty of the Ergotrid: A Novel Treatment Technique for Severe Dynamic Lip Lines.

Dynamic lip lines pose a challenge in perioral rejuvenation despite the availability of numerous hyaluronic acid dermal filler products and techniques. In this article, the authors introduce additive orthodiagonal rhytidoplasty of the ergotrid, or ADORE, a novel technique for the treatment of severe dynamic lip lines. Based on an objective analysis of treatment outcomes, the authors' technique demonstrates the ability to confer substantial improvement in dynamic lip line severity, with a median reduction in lip line intensity of 79% (average, 70%; SD, 19%) at 1 month and 72% (average, 61%; SD, 21%) at 6 months, and a high degree of patient satisfaction.

Needle Microcores: Can They Pose an Occlusive Threat with Nonparticulate Injections?

Summary: The incidence of vascular occlusion injuries has risen substantially along with the increasing popularity of cosmetic injectables. Among these occurrences, instances of soft-tissue ischemic events following the injection of nonparticulate solutions, such as botulinum, represent an enigmatic etiology that has yet to be fully understood. One hypothesized mechanism of injury underlying these events relates to the accidental capture and intravascular ejection of needle microcores, defined as submillimeter tissue fragments trapped by the beveled lumen of a needle during conventional injections.

Patterns of Filler-Induced Facial Skin Ischemia: A Systematic Review of 243 Cases and Introduction of the FOEM Scoring System and Grading Scale.

Background: The incidence of facial skin necrosis has increased considerably because of the growth in the popularity of dermal fillers. This study describes the patterns and severity of facial skin ischemia, along with associated neuro-ophthalmologic injuries, in the published literature through the introduction of the facial artery, ophthalmic artery, distal external carotid artery, internal maxillary artery (FOEM) facial angiosome scoring system and grading scale.

Methods: A systematic review of all photographic cases of facial skin ischemia attributable to vascular occlusion with dermal fillers and injectable materials was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.