The safety and effectiveness of low-level light therapy (LLLT) with light-emitting diode (LED) bed system and a novel topical anti-cellulite gel on grades 1-2 thigh/buttock cellulite: a randomized, comparative-controlled split-thigh/buttock IRB study.

Background: Cellulite of the upper lateral and posterior thighs and lower buttocks represents a common unwanted condition.

Objectives: The author sought to comparea LLLT-LED bed therapy and a novel topical anti-cellulite gel on one thigh/buttock cellulite vs light therapy for cellulite to the opposite side.

Methods: Eight healthy female subjects were randomly treated with a LLLT-LED bed twice weekly for 20 minutes in prone/supine positions with twice daily application of a novel anti-cellulite gel to one randomized thigh/buttock.

Clinical Use of Extracellular Vesicles in the Management of Male and Female Pattern Hair Loss: A Preliminary Retrospective Institutional Review Board Safety and Efficacy Study.

Background: Pattern hair loss is a common disorder in female and male patients.

Objectives: To assess the safety, efficacy, and satisfaction of a single extracellular vesicle (EV) treatment over 6 months.

Methods: A retrospective open-label study among 22 female and 9 male patients who demonstrated early stages of alopecia or were in remission from previous medical and surgical treatments.

The Effects of Lower vs Higher Cell Number of Platelet-Rich Plasma (PRP) on Hair Density and Diameter in Androgenetic Alopecia (AGA): A Randomized, Double-Blinded, Placebo, Parallel-Group Half-Scalp IRB-Approved Study.

Background: Androgenetic alopecia (AGA) is a common disorder in both males and females and may be improved by platelet-rich plasma (PRP) treatment.

Objectives: The aim of this study was to compare safety, efficacy, and satisfaction following treatment with a lower or higher number of platelets over 6 months.

Methods: This was a prospective randomized, double-blinded, placebo, parallel-group, half-scalp IRB-approved study involving 8 subjects with moderate AGA.

The Significance of Trans-Epidermal Water Loss After Microneedling and Microneedling-Radiofrequency Procedures: Histological and IRB-Approved Safety Study.

Background: Microneedling (MN) and microneedling-radiofrequency (MN-RF) result in skin rejuvenation and skin exposure to pathogens.

Objectives: The aim was to determine histopathological changes of needle-depth injuries in preauricular skin and measure time-dependent repair of transepidermal water loss (TEWL) in subjects.

Methods: MN and MN-RF procedures were performed at 0.

A Preliminary Clinical Trial Comparing Split Treatments to the Face and Hand With Autologous Fat Grafting and Platelet-Rich Plasma (PRP): A 3D, IRB-Approved Study.

Background: Numerous methodologies have been suggested to enhance fat graft survival, but few long-term studies are available.

Objectives: The authors of this institutional review board-approved study investigated the safety and efficacy of utilizing platelet-rich plasma (PRP).

Methods: Each of 10 patients received equal volumes of syringe-harvested, centrifuged fat to opposing midfaces with a lateral submuscular aponeurotic system-plication or no face lift and hands that were combined with equal volumes of either concentrated PRP or normal saline.

Review of Human Hair Follicle Biology: Dynamics of Niches and Stem Cell Regulation for Possible Therapeutic Hair Stimulation for Plastic Surgeons.

Plastic surgeons are frequently asked to manage male- and female-pattern hair loss in their practice. This article discusses the epidemiology, pathophysiology, and current management of androgenetic alopecia and emphasizes more recent knowledge of stem cell niches in hair follicles that drive hair cycling, alopecia, and its treatment. The many treatment programs available for hair loss include newer strategies that involve the usage of growth factors, platelet-rich plasma, and fat to stimulate follicle growth.

A Split Face Study to Determine the Significance of Adding Increased Energy and Treatment Levels at the Marionette Folds.

Background: Microfocused ultrasound with visualization (MFU-V) has become a safe and effective means to tighten skin and subdermal structures by optimizing the amount of joule energy and treatment tissue planes for improved customization for the individual patient. To date, there have been an absence of split treatments to verify algorithms.

Objectives: The aims of this institutional review board-approved investigation and clinical experience were to clarify the safety and efficacy of current treatment guidelines.

Micro-Needling Depth Penetration, Presence of Pigment Particles, and Fluorescein-Stained Platelets: Clinical Usage for Aesthetic Concerns.

Background: Aesthetic micro-needling (MN) has demonstrated skin permeability to cosmeceutical ingredients and platelet-rich plasma by creating reversible micro-channels in the skin.

Objectives: The purposes of this study were to determine: (1) actual needle depth-penetrations by adjusting needle lengths in a disposable tip of an electric MN device; (2) time-dependent passage of pigment and platelets; and (3) safety and efficacy profiles in patients.

Methods: Excised micro-needled pre-auricular skin was used to determine actual depths of tissue penetration with six needle lengths, and the presence of massaged pigment particles (histological examination) and fluorescein-labeled platelets (confocal laser microscopy) in 1 mm depth micro-channels over an hour.

A Multicenter Study for Cellulite Treatment Using a 1440-nm Nd:YAG Wavelength Laser with Side-Firing Fiber.

Background: Treatment of cellulite using a 1440-nm YAG wavelength laser with side-firing fiber has proven safe and effective, lasting at least 6 months.

Objectives: The authors evaluate the safety and efficacy of a single, subdermal procedure to treat the underlying structure of cellulite for at least 1 year.

Methods: Fifty-seven patients underwent a 3-step cellulite treatment with a 1440-nm Nd:YAG laser with a side-firing fiber and temperature-sensing cannula.

The Safety and Efficacy of Cell-Assisted Fat Grafting to Traditional Fat Grafting in the Anterior Mid-Face: An Indirect Assessment by 3D Imaging.

Background: Numerous methodologies and algorithms have been suggested to enhance fat graft survival, including the usage of stromal vascular fraction (SVF) and platelet-rich plasma (PRP), but no long-term studies are available.

Objectives: This single-center prospective, case-controlled study investigated the safety and efficacy of combining a modified Baker-designed lateral SMASectomy or plication face lift with simultaneous anterior mid-face grafting into site-specific compartments by (1) conventional Coleman's technique or (2) Yoshimura's cell-assisted lipografting technique.

Methods: On the voluntary principle, candidates selected one of four techniques for volumization of their mid-face: conventional fat grafting; PRP-assisted fat grafting; SVF-assisted fat grafting; and PRP/SVF- assisted fat grafting.

Cryolipolysis for fat reduction and body contouring: safety and efficacy of current treatment paradigms.

Background: Cryolipolysis is a nonsurgical technique for localized fat reduction. With the increased risk of complications from more invasive methods such as liposuction, cryolipolysis presents a promising method for nonsurgical body contouring. This study presents a systematic review of the available clinical data, with an emphasis on the efficacy, methods, safety, and complications of cryolipolysis.

Noninvasive selective cryolipolysis and reperfusion recovery for localized natural fat reduction and contouring.

Background: Cryolipolysis is a contemporary method of reducing fat by controlled extraction of heat from adipocytes.

Objectives: The authors recorded temperature profiles during a single cryolipolysis treatment/recovery cycle (with and without massage) and report on the clinical safety and efficacy of this procedure.

Methods: In the pilot study group (PSG), the abdomens of 6 patients were treated with cryolipolysis and subdermal temperatures were recorded.

Single treatment of grades II and III cellulite using a minimally invasive 1,440-nm pulsed Nd:YAG laser and side-firing fiber: an institutional review board-approved study with a 24-month follow-up period.

Background: Cellulite represents one of the common topographic alterations to the skin surface and one of the structural changes to the subdermal fat and septal band of the posterolateral thighs. Currently, no treatment exists to address this entity with a multifactorial genesis that produces long-term beneficial outcomes. This clinical study evaluated the safety and efficacy of the 1,440-nm laser and the duration of the clinical benefits during 2 years.

A multicenter study for a single, three-step laser treatment for cellulite using a 1440-nm Nd:YAG laser, a novel side-firing fiber, and a temperature-sensing cannula.

Background: Historically, treatments for cellulite have not been able to address all of its physiological components and require multiple sessions.

Objective: The authors evaluate the safety and efficacy of a single, subdermal procedure to treat the underlying structure of cellulite.

Methods: Fifty-seven patients underwent a 3-step cellulite treatment with a 1440-nm Nd:YAG laser with a side-firing fiber and temperature-sensing cannula.

Early clinical experience with the 1440-nm wavelength internal pulsed laser in facial rejuvenation: two-year follow-up.

This article reports on the early experience with the 1440-nm wavelength, using a specially designed side-firing fiber, in a four-step approach, primarily to the lower third of the midface and neck. The author presents the clinical protocol, procedure steps, outcomes, and adverse events of use of the laser. Outcomes are described at 3 months, 6 months, and 18 months.

Tissue restructuring by energy-based surgical tools.

Energy-based noninvasive surgical tools can be used for ablative bio-stimulation (eg, collagen production) or tissue restructuring functions (eg, tightening or lifting) and are the subject of this review. The authors present the various methods and tools for noninvasive cosmetic surgery (ultrasound, radiofrequency, cryolipolysis, and lasers) and present the clinical outcomes of each. They summarize techniques and methods and their indications, physical parameters and tissue target, and consistency.

Clinical efficacy and safety of focused-image ultrasonography: a 2-year experience.

Background: Focused-image ultrasonography produces controlled waves that image dermal and subdermal structures in real time, with precise thermal coagulation points in a linear pattern, for eventual nonsurgical lifting.

Objectives: The authors evaluate the effectiveness of single and dual planes of ultrasound treatment by varying the directions of treatment lines, depths, and cumulative joule energies and compare the safety and efficacy of treatment with these variations.

Methods: In this prospective, 2-part study, patients were treated by single- or dual-treatment depth with differing directions of treatment lines while the number of treatment lines and amount of energy delivered to brows or marionette lines remained constant (Study 1) or with lower or higher joule energy to opposing areas while the dual depths and number of vectored lines remained constant (Study 2).

Water-assisted liposuction for body contouring and lipoharvesting: safety and efficacy in 41 consecutive patients.

Background: Water-assisted liposuction (WAL) is a new technique for body contouring and fat harvesting that relies on a fan-shaped jet of tumescent solution to anesthetize fatty for liposuction and grafting. As with any new technology, safety and efficacy are paramount.

Objective: The author evaluates the technique and outcomes for small-to-moderate volume liposuction cases treated with WAL in an office setting.

Quantification of human abdominal tissue tightening and contraction after component treatments with 1064-nm/1320-nm laser-assisted lipolysis: clinical implications.

Internal lipoplasty (iLAL) represents an evolving procedure that depends on delivery of sufficient and controlled thermal energy for lipolysis and collagen denaturation. Of the two outcomes, the particular advantage of iLAL may exist in its capability to selectively denature, remodel, and contract collagen and elastin fibers for eventual skin contraction. Despite the practice of sound laser principles and clinical outcomes, laser lipolysis has not been readily accepted because of its yet unproven advantages over other liposuction devices.

Laser-assisted liposuction for facial and body contouring and tissue tightening: a 2-year experience with 75 consecutive patients.

Internal liposuction remains the standard and most reliable method to remove fat and contour the face and body. The recent introduction (2006 FDA clearance) of a higher and more controlled energized internal laser system is purported to increase tissue contraction and damage unwanted fat deposits through dual 1064 nm/1320-nm wavelengths that are initially used at a deep level of subcutaneous fat, and subsequently at a shallow level beneath the dermis along with liposuction. Using classical principles of selective photothermolysis, the sequential exposure of these wavelengths on target tissue chromophores results in selective thermo-lipolysis and thermo-denaturation of collagen fibers (H(2)O) within the septal architecture and lower reticular dermis for enhanced skin retraction (accommodation) and contraction.

Fractional CO2 laser resurfacing of photoaged facial and non-facial skin: histologic and clinical results and side effects.

Background: CO(2) fractional ablation offers the potential for facial and non-facial skin resurfacing with minimal downtime and rapid recovery.

Objectives: The purpose of this study was (i) to document the average depths and density of adnexal structures in non-lasered facial and non-facial body skin; (ii) to determine injury in ex vivo human thigh skin with varying fractional laser modes; and (iii) to evaluate the clinical safety and efficacy of treatments.

Methods: Histologies were obtained from non-lasered facial and non-facial skin from 121 patients and from 14 samples of excised lasered thigh skin.

Comparison of results of wire subcision performed alone, with fills, and/or with adjacent surgical procedures.

Background: Because of the fixed attachments (or muscle-superficial musculoaponeurotic system [SMAS] insertions) to the undersurface of wrinkles, folds, and retracted scars, the use of fills alone has resulted in unpredictable and unsatisfactory improvements.

Objective: To demonstrate that use of a wire dissector to completely release these attachments, accompanied by an immediate fill and/or an adjacent aesthetic surgical procedure, may optimize final results, improving deep wrinkles, folds, and scars.

Methods: The subcision wire was positioned under various wrinkles, folds, and scars in a triangulated outline and then zigzagged to uniformly release any subdermal attachments.