Injectable Poly-L-Lactic Acid for Body Aesthetic Treatments: An International Consensus on Evidence Assessment and Practical Recommendations.

Non-facial (body) rejuvenation is a treatment of increasing demand, with patients seeking to harmonize the benefits of rejuvenated facial appearance with other areas of the body. Poly-L-lactic acid (PLLA)-SCA (Sculptra®) has been approved for facial aesthetic uses since 1999 in Europe and since 2009 in the USA and more recently evaluated for the treatment of cellulite of the buttocks and thighs and other body indications. The current evidence base consists largely of prospective observational analyses and case series although systematic evaluations for a number of body areas are underway.

Microfocused Ultrasound With Visualization (MFU-V) Effectiveness and Safety: A Systematic Review and Meta-Analysis.

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.

SPLASH: Split-Body Randomized Clinical Trial of Poly- l -Lactic Acid for Adipogenesis and Volumization of the Hip Dell.

Background: Injectable poly- l -lactic acid (PLLA-SCA) increases extracellular matrix to improve skin quality. The hip dell is an underappreciated element of gluteal aesthetics. Adipose tissue has roles in aesthetics and skin functioning.

INDIVIDUAL ARTICLE: Real-World Clinical Experience With a Neuro-Peptide Serum in Combination With Botulinum Toxin Type-A Injections.

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.

From CO2 to Er:YAG: A Comprehensive Review of Laser Treatments for Rhinophyma.

Background: Rhinophyma, a benign condition resulting in nasal sebaceous tissue hypertrophy, predominantly affects Caucasian males. There are numerous surgical and medical treatments for rhinophyma with varying degrees of success. This review aims to provide a comprehensive overview of ablative therapies, highlighting our preferred treatment approach.

Midface Projection Using Biostimulatory Poly- l -Lactic Acid Injectable Implant: A Subgroup Analysis of the Cheek Wrinkle Trial.

Background: Correction of cheek wrinkles using poly- l -lactic acid (PLLA-SCA) was demonstrated in a 12-month study.

Objective: This analysis assessed change from baseline in lifting effect of PLLA-SCA using a 3D camera to provide additional quantified data.

Methods: Subjects received PLLA-SCA (reconstituted in 8 mL of sterile water + 1 mL of 2% lidocaine) in both cheeks or no treatment (control).

Optimal Practices in the Delivery of Aesthetic Medical Care to Patients on Immunosuppressants and Immunomodulators: A Systematic Review of the Literature.

Nonsurgical aesthetic procedures have been steadily growing in popularity among patients of all ages and ethnicities. At present, the literature remains devoid of guidelines on optimal practices in the delivery of aesthetic medical care to patients on immunosuppressant medications. The authors of this review sought to determine the physiologic responses of immunocompromised patients related to outcomes and potential complications following nonsurgical aesthetic procedures, and to suggest recommendations for optimal management of these patients.

A Review of Neuromodulators and Energy-Based Devices for Optimizing Nasal Appearance.

The demand for less invasive nasal procedures has been increasing, highlighting a gap in research on alternatives beyond fillers. This review explores the potential of neuromodulators and energy-based devices for nonsurgical rhinoplasty. Both botulinum toxin and energy-based devices used independently or alongside fillers have been studied for nasal shape adjustments.

Decoding the Implications of Glucagon-like Peptide-1 Receptor Agonists on Accelerated Facial and Skin Aging.

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.

A Practical Algorithm Integrating Skin Care With Nonenergy and Injectable Dermatologic Procedures to Improve Patient Outcomes and Satisfaction.

Background: The most rapidly increasing medical aesthetic procedures for facial antiaging comprise nonenergy and injectable treatments. Currently, standards for skin care before, during, and after nonenergy and injectable treatments are lacking. The algorithm on supportive skin care for facial antiaging nonenergy and injectable treatments aims to stimulate healing, reduce downtime, and improve comfort and treatment outcomes.

A Review of Aesthetic Considerations for Treating the Transgender Patient.

Background: As gender diversity becomes increasingly embraced by society, and despite growing recognition of the unique needs of transgender patients, the literature remains devoid of guidelines for gender affirming facial feminization or masculinization techniques.

Objective: The authors seek to identify and discuss target feminine and masculine facial features, as well as an armamentarium of surgical and nonsurgical strategies to effectively address and achieve them in the transgender population.

Methods: A search of the National Library of Medicine database (PubMed) was undertaken to identify the existing literature on gender-affirming facial feminization and masculinization techniques.

Extension Phase of a Multi-Center, Randomized, Blinded Clinical Study Evaluating the Efficacy and Safety of a Novel Topical Product for Facial Dyschromia.

Background: Dyschromia can be associated with increased production and/or reduced clearance of pigmentation in the skin. Multiple pathways are involved in causality. A novel topical product was recently developed, which contains actives that have been validated through in-vitro and clinical studies to counteract pigmentation related to photodamage, PIH, and melasma.

Treatment of acne in the aesthetic patient: A round table update.

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.

Update: Cellulite Therapies and Optimizing Treatment Combinations.

Cellulite in the proximal lower extremities is a reported concern among many adult females. The unsightly appearance of cellulite leads many affected individuals to seek treatment by trained specialists. The objective of this review is to provide the reader with an update on new and innovative therapies for cellulite including various treatment combinations to maximize therapeutic outcomes, and strategies for minimizing adverse events.

Esthetic considerations for treating the patient of European descent: Thriving in diversity international roundtable series.

Background: The European esthetic experience is informative for understanding both innovation as well as how to care for patients of various backgrounds and ages.

Aims: To discuss best practices for treating the European population and how these approaches may be applied to patient populations across the globe.

Patients/methods: In support of clinicians who wish to serve a diverse patient population, a 6-part, international roundtable series focused on diversity in esthetics was conducted from August 24, 2021 to May 16, 2022.

Aesthetic considerations when treating patients of African descent: Thriving in diversity international roundtable series.

Background: Black patients of African descent are an ethnically diverse demographic and have unique anatomical features, aging processes, and responses to aesthetic procedures that must be considered when planning treatment.

Aims: To discuss similarities and differences in the anatomy and treatment preferences of Black patients of African descent and explore how these differences may influence 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.

Microtoxin for Improving Pore Size, Skin Laxity, Sebum Control, and Scars: A Roundtable on Integrating Intradermal Botulinum Toxin Type A Microdoses Into Clinical Practice.

Background: In aesthetic clinical practice, botulinum toxin type A (BoNT-A) is best known for its use as a neuromodulator for the treatment of dynamic facial lines; however, when injected intradermally as microdroplets, BoNT-A can improve skin quality and overall skin appearance.

Objectives: To discuss key aspects of microtoxin use in clinical practice and provide expert guidance on utilization.

Methods: As part of a continuing medical education lecture series and roundtable, the authors discussed key aspects of microtoxin patient selection, injection technique, and safety.

Collagenase Clostridium Histolyticum-aaes Injections for Volumetric Change of Cellulite Dimples and Gluteal Contouring.

Background: Collagenase clostridium histolyticum-aaes (CCH) is approved for the treatment of moderate-to-severe cellulite.

Objective: This is a retrospective image review of subjects previously enrolled in Cohort 2 of the EN3835-305 trial to determine the effects of CCH on volumetric changes of cellulite dimples and overall gluteal contouring.

Methods: In this retrospective analysis, photographs from Day 90 and Day 180 were superimposed on baseline images and the volumetric change of each treated cellulite dimple was quantified.

Making Sense of Late Tissue Nodules Associated With Hyaluronic Acid Injections.

Background: The pathogenesis of delayed-onset tissue nodules (DTNs) due to hyaluronic acid (HA) injections is uncertain.

Objectives: To formulate a rational theory for DTN development and their avoidance and treatment.

Methods: A multidisciplinary and multicountry DTN consensus panel was established, with 20 questions posed and consensus sought.