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Background: Skin aging is the most obvious feature of human aging, and delaying aging has become a hot and difficult research topic in aesthetic medicine. The accumulation of dysfunctional senescent cells is one of the important mechanisms of skin aging, based on which a series of anti-aging strategies have been generated. In this paper, from the perspective of cellular senescence, we utilize bibliometrics and research review to explore the research hotspots and trends in this field, with a view to providing references for skin health and aesthetic medicine. Methods: We obtained literature related to this field from the Web of Science Core Collection database from 1994 to 2024. Bibliometrix packages in R, CiteSpace, VOSviewer, Origin, and Scimago Graphica were utilized for data mining and visualization. Results: A total of 2,796 documents were included in the analysis. The overall trend of publications showed a continuous and rapid increase from 2016-2023, but the total citations improved poorly over time. In this field, Journal of Cosmetic Dermatology, Journal of Investigative Dermatology, Experimental Gerontology are core journals. Kim J, Lee JH, Lee S, Rattan SIS, Chung JH and Kim JH are the core authors in this field. Seoul National University is the first in terms of publications. Korea is the country with the most publications, but USA has the most total citations. Top 10 keywords include: gene-expression, skin, cellular senescence, cell, oxidative stress, antioxidants, in vitro, fibroblasts, mechanism, cancer. Current research trends are focused on neurodegeneration, skin rejuvenation, molecular docking, fibrosis, wound healing, SASP, skin barrier, and antioxidants. The core literature and references reflect topics such as the major molecular pathways in the aging process, and the relationship with tumors. Conclusion: This field of research has been rapidly rising in recent years. Relevant research hotspots focus on oxidative stress, fibroblasts, and senescence-associated secretory phenotype. Anti-aging strategies targeting cellular senescence hold great promise, including removal of senescent cells or attenuation of SASP factors, corresponding to senolytics and senomorphics therapies, respectively.
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BACKGROUND: Aesthetic neuromodulator injections of the upper face are frequently performed to temporarily block muscular actions of the periorbital muscles to ultimately reduce skin rhytids. However, the adverse event rate in the literature for toxin-induced blepharoptosis ranges from 0.51% to 5.4%. OBJECTIVE: To identify access pathways by which injected neuromodulator product can travel from extra- to intra-orbital and therefore affect the levator palpebrae superioris muscle. METHODS: Nine non-embalmed human body donors were investigated in this study with a mean age at death of 72.8 (16.1) years. The 18 supraorbital regions were injected in 28 times (14 for supratrochlear and 14 for supraorbital) with 0.5 cc, whereas eight cases (four for supratrochlear and four supraorbital) were injected with 0.1 cc of colored product. Anatomic dissections were conducted to identify structures stained by the injected color. RESULTS: The results of this injection- and dissection-based study revealed that both the supratrochlear and the supraorbital neurovascular bundles are access pathways for injected neuromodulator products to reach the intra-orbital space and affect the levator palpebrea superioris muscle. Out of 36 conducted injection passes, seven (19.44%) resulted in affection of the sole elevator of the eyelid of which 100% occurred only at an injection volume of 0.5 cc and not at 0.1 cc. CONCLUSION: Clinically, the results indicate that a low injection volume, a superficial injection for the supraorbital location, and angling the needle tip away from the supratrochlear foramen (toward the contralateral temple) when targeting the corrugator supercilii muscles, can increase the safety profile of an aesthetic toxin glabellar treatment.
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BACKGROUND: Poly-l-lactic acid (PLLA) injectables have gained increasing attention in aesthetic medicine due to their biocompatibility and long-lasting effects. Although their primary application centers around facial rejuvenation, their potential for off-label use in other body areas has been investigated, demonstrating promising outcomes in terms of both efficacy and safety. AIM: This study aims to assess the safety and efficacy of a novel 630 mg PLLA-based filler (GANA X), in buttocks treatment. METHODS: Six physicians treated 51 patients for buttock aesthetic treatment across six different medical facilities in Italy. A survey was filled by both physicians and patients regarding treatment safety, efficacy, and change in quality of life. RESULTS: We reported minor or mild adverse events, self-resolving within the next few days. Both physicians and patients confirmed notable aesthetic improvements following treatment, varying from moderate to significant enhancement. These effects endured throughout follow-up visits spanning up to 24 months. Patient-reported outcomes indicated elevated self-esteem and improved quality of life posttreatment. CONCLUSIONS: The high level of satisfaction reported by both physicians and patients highlights the efficacy and tolerability of GANA X filler for buttocks treatment, encouraging their use and research for off-label body areas.
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BACKGROUND: Cellulite is a cosmetic defect of multifactorial etiology that affects over 90% of women worldwide. Cellulite-induced skin changes are undesirable and negatively affect self-esteem. Despite a plethora of cellulite-reducing treatments, we still lack objective tools to enable accurate diagnosis and treatment efficacy assessment. The aim of this study was to determine whether high-frequency ultrasound can be helpful in assessing cellulite and whether there is an association between ultrasound-derived measurements, parameters ascertained clinically, and cellulite assessment scale scores. METHODS: The study group consisted of 114 women with cellulite in their posterior thighs, assessed using the Nürnberger-Müller scale. Two types of ultrasound devices were used in this study: a conventional scanner with a linear transducer and a skin-dedicated scanner equipped with a mechanical transducer. We used high-frequency ultrasonography to determine epidermal thickness, dermal thickness, the surface area of fat protrusions at the dermal subcutaneous junction, and the thickness and stiffness of the subcutaneous tissue (ultrasound elastography). RESULTS: There was a correlation between cellulite severity and subcutaneous tissue thickness (r = 0.63), the surface area of fat protrusions at the dermal subcutaneous junction (r = 0.64), and the elastographic strain ratio (r = 0.51). An association was also demonstrated between thigh circumference and subcutaneous tissue thickness (r = 0.48). There was a significant difference in the assessed parameters between the subgroups identified by cellulite severity scores. CONCLUSIONS: Ultrasound-determined surface area of fat protrusions at the dermal subcutaneous junction as well as the thickness and stiffness of the subcutaneous tissue seem useful in cellulite assessment. Thus, ultrasonography has the potential to become a common tool in aesthetic medicine and cosmetology.
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Aesthetic medicine has grown exponentially in recent decades, becoming a key part of healthcare and wellness, with distinct generational demands shaping its landscape. Baby Boomers seek youthful rejuvenation, preferring noninvasive treatments like botulinum toxin injections and dermal fillers. Generation X favors natural, minimally invasive enhancements, often influenced by authentic testimonials. Millennials, driven by social media and self-care trends, prioritize preventive and enhancement procedures, sharing their experiences online. Generation Z, influenced by social media and digital beauty standards, focuses on prejuvenation and temporary enhancements. For industry professionals, understanding these generational dynamics and leveraging social media is essential to meet diverse patient expectations and enhance engagement.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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BACKGROUND: The FACE-Q Aesthetics is used extensively to measure patient reported outcomes for minimally invasive and surgical facial aesthetic treatments. We recently developed a new FACE-Q scale to assess satisfaction with the appearance of the temples. AIM: The aim of this study was to field test the FACE-Q Satisfaction with Temples scale to examine its psychometric properties. METHODS: The FACE-Q Satisfaction with Temples scale was administered to 171 adults (22 years or older) seeking minimally invasive treatment to improve temple hollowing as part of a clinical trial. The severity of temple hollowing was established through the clinician-reported Allergan Temple Hollowing scale (clinician-rated). The psychometric properties of the FACE-Q Satisfaction with Temples scale were established by testing Rasch Measurement Theory (RMT) assumptions and model fit; unidimensionality by principal component analysis; and construct validity by hypothesis testing. RESULTS: The study sample consisted of 171 adults (mean age 54.7 ± 9.9, range, 25-82 years). RMT analysis provided evidence for the scientific soundness of a 12-item Satisfaction with Temples scale. The data fit the Rasch model (χ2 = 20.47, df = 24, p = 0.67), all items had ordered thresholds, and good item fit. Scale reliability was high, with Person Separation Index and Cronbach alpha values with and without extremes ≥0.93. Principal component analysis revealed a single component with high factor coefficients. Construct validity was established as scores for the Satisfaction with Temples and Face Overall scales were correlated (r = 0.623, p < 0.001). CONCLUSION: The FACE-Q Satisfaction with Temples scale is a reliable and valid measure that can be used in clinical practice and research to measure outcomes following treatment for temple hollowing.
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BACKGROUND: Aesthetic medicine has traditionally relied on clinical scales for the objective assessment of baseline appearance and treatment outcomes. However, the scales focus on limited aesthetic areas mostly and subjective interpretation inherent in these scales can lead to variability, which undermines standardization efforts. OBJECTIVE: The consensus meeting aimed to establish guidelines for AI application in aesthetic medicine. MATERIALS AND METHODS: In February 2024, the AI Consensus Group, comprising international experts in various specialties, convened to deliberate on AI in aesthetic medicine. The methodology included a pre-consensus survey and an iterative consensus process during the meeting. RESULTS: AI's implementation in Aesthetic Medicine has achieved full consensus for enhancing patient assessment and consultation, ensuring standardized care. AI's role in preventing overcorrection is recognized, alongside the need for validated objective facial assessments. Emphasis is placed on comprehensive facial aesthetic evaluations using indices such as the Facial Aesthetic Index (FAI), Facial Youth Index (FYI), and Skin Quality Index (SQI). These evaluations are to be gender-specific and exclude makeup-covered skin at baseline. Age and gender, as well as patients' ancestral roots, are to be considered integral to the AI assessment process, underlining the move towards personalized, precise treatments. CONCLUSION: The consensus meeting established that AI will significantly improve aesthetic medicine by standardizing patient assessments and consultations, with a strong endorsement for preventing overcorrection and advocating for validated, objective facial assessments. Utilizing indices such as the FAI, FYI, and SQI allows for gender-specific, age adjusted evaluations and insists on a makeup-free baseline for accuracy.
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BACKGROUND: Aesthetic medicine has evolved significantly, accommodating diverse demographics and motivations influenced by societal shifts and technological advancements. The IMPACT (integrative multigenerational psychological analysis for cosmetic treatment) study refines patient archetypes, integrating psychological theories to tailor treatments, especially for younger demographics and LGBTQIA + communities. METHODS: This cross-sectional study utilized a comprehensive, validated survey with a Cronbach's alpha of 0.89 and a Content Validity Index (CVI) of 0.92, distributed across a globally diverse, generationally stratified sample. Techniques like regression analysis, ANOVA, Bayesian modelling, and factor analysis were employed to analyse the data, focusing on developing nuanced patient archetypes. RESULTS: Among 5645 participants, 5340 complete responses highlighted significant generational differences in aesthetic preferences. Millennials showed a strong preference for non-invasive procedures (ß = 0.65, p < 0.001). ANOVA results confirmed significant variances across generations [F (3, 5118) = 157.6, p < 0.001], with post-hoc analyses delineating specific inter-group differences. Bayesian modelling provided insights into the probability of non-invasive preferences among younger cohorts at over 92% certainty. Factor analysis revealed key dimensions such as 'Generational Influence' and 'Technological Adoption,' which helped in defining archetypes including Dynamic Self-Identity, Digital Native, Stability Seeker, Classic Conservatism, and Holistic Health, collectively explaining up to 78% of the variance in responses. CONCLUSION: The IMPACT study underscores the influence of generational identity and digital exposure on aesthetic preferences, advocating for personalized, archetype-based treatment approaches. This aligns with enhancing patient satisfaction and treatment outcomes, promoting an adaptive aesthetic medicine practice that meets the evolving needs of modern patients. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Breast cancer, a prevalent malignancy among women, has various physical and psychological impacts. This comprehensive review offers an in-depth look at multidisciplinary dermo-aesthetic intervention approaches, emphasizing the balance between oncological therapies and the management of these effects. The information presented spans specialties such as aesthetic medicine, plastic surgery, dermatology, physiotherapy, nutrition, odontology, and gynecology. This review, which serves as a clinical guide, aims to establish a safe protocol for non-medical interventions involving oncologists, physicians, and specialists from various areas in patients with breast cancer focused on improving their quality of life. This work offers personalized and integrative care strategies for the eradication of cancer. However, it is still necessary for patients to consult with their oncologist before undergoing any dermo aesthetic treatment. However, it is still necessary for patients to consult with their oncologist before undergoing any dermo aesthetic treatment.
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The two cases discussed in this report investigate the efficacy and safety of a novel injectable therapy for treating neck wrinkles and skin laxity, utilizing a combination of hyperdiluted calcium hydroxylapatite (CaHA), platelet-rich plasma (PRP), and hyaluronidase. Two patients presenting with moderate neck wrinkles and laxity underwent treatment and were evaluated several months later. The combined therapy demonstrated improvements in skin texture and laxity following a single treatment. The rationale behind incorporating PRP and hyaluronidase was their potential to amplify the regenerative effects of CaHA. PRP contains growth factors that stimulate collagen production and tissue regeneration while hyaluronidase facilitates the breakdown of hyaluronic acid, promoting better diffusion and more even product dispersion. The findings from these cases provide emerging preliminary evidence supporting the safety and efficacy of this innovative combination therapy for addressing neck wrinkles and laxity. This is the first documented instance of skin priming CaHA with hyaluronidase and PRP. Future investigations are warranted to explore the application of this treatment for other anatomical regions and to delineate the role of each injected component.
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Polynucleotides, complex molecules composed of nucleotides, have gained attention in aesthetic medicine for their potential to regulate gene expression and promote tissue regeneration. This review aims to provide an overview of the current practices and perceived effectiveness of polynucleotides in aesthetic medicine. A comprehensive search of the literature was conducted using keywords related to polynucleotides, cosmetic application, and aesthetic application. Studies were selected based on their relevance to aesthetic medicine and the inclusion of human subjects. The review found that polynucleotides have been used to improve skin texture, reduce wrinkle depth, and enhance facial appearance. The studies reported varying degrees of efficacy and safety, with some studies demonstrating significant improvements in skin elasticity and hydration. However, others reported limited or no benefits. The review also highlighted the need for further research to establish the optimal use and efficacy of polynucleotides in aesthetic medicine. While the existing literature suggests that polynucleotides may have potential benefits in aesthetic medicine, more research is needed to fully understand their mechanisms of action and optimal use. Clinicians should be aware of the current limitations and potential risks associated with the use of polynucleotides in aesthetic medicine.
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Polinucleotídeos , Humanos , Polinucleotídeos/uso terapêutico , Estética , Envelhecimento da Pele/efeitos dos fármacos , Técnicas CosméticasRESUMO
Intradermal injection of bioactive compounds is used to reduce the effects of aging skin. The aim of this work is to study the response of facial injection of a hyaluronic acid complex supplemented with amino acids and antioxidant vitamins on skin rejuvenation. A total of 40 healthy adult subjects were recruited to whom this complex was injected into the facial skin, three consecutive times every two weeks. Together with assessing the degree of skin hydration, the level of skin microcirculation, wrinkles, skin color, and skin biomechanical parameters were evaluated. Using the GAIS scale, the degree of satisfaction of the participants was assessed. At 42 days (D42), there was an 11-12% increase in skin hydration and viscoelasticity, a 23% increase in skin density, a 27% increase in skin microcirculation, and a significant lightening and whitening of skin color, but without causing changes in skin wrinkles. A value between 1 and 3 on the GAIS scale was observed between 70 and 92% of the participants, and 87% of subjects found their skin more beautiful, 85% would recommend this treatment, and more than 50% found their face rejuvenated. In summary, the intradermal treatment tested suggests skin rejuvenation, with a good degree of safety.
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BACKGROUND: Patient-reported outcome measures (PROMs) for hair loss focus mainly on Alopecia Areata. We created a PROM (i.e., HAIR-Q) that is applicable to any hair loss condition. The HAIR-Q measures satisfaction with hair. PATIENTS/METHODS: Concept elicitation interviews were conducted and analyzed to develop a draft scale. Content validity was established through multiple rounds of patient and expert input. Psychometric properties of the scale were examined in an online sample (i.e., Prolific) using Rasch measurement theory (RMT) analysis. Test-retest reliability and tests of construct validation were examined. RESULTS: Content validity of a 22-item draft scale was established with input from 11 patients, 12 experts and an online Prolific sample of 59 people who had a variety of hair loss treatments. In the RMT analysis (n = 390), 8 items were dropped. Data for the 14-item scale fit the Rasch model (χ2 = 89.85, df = 70, p = 0.06). All 14 items had ordered thresholds and good item fit. Reliability was high with person separation index and Cronbach alpha values ≥0.91, and intraclass correlation coefficient of 0.94 based on a sample of 97 participants. Higher (better) scores on the scale were associated with having more hair, looking younger than ones' age, satisfaction with hair overall, being less bothered by hair loss, and for those who had a hair loss treatment in the past year, being more satisfied with their hair now than before treatment (p < 0.001). CONCLUSION: The HAIR-Q evidenced reliability and validity and can be used in research and to inform clinical care to measure satisfaction with hair from the patient perspective.
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Bioproducts derived from platelets have been extensively used across various medical fields, with a recent notable surge in their application in dermatology and aesthetic procedures. These products, such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), play crucial roles in inducing blood vessel proliferation through growth factors derived from peripheral blood. PRP and PRF, in particular, facilitate fibrin polymerization, creating a robust structure that serves as a reservoir for numerous growth factors. These factors contribute to tissue regeneration by promoting cell proliferation, differentiation, and migration and collagen/elastin production. Aesthetic medicine harnesses these effects for diverse purposes, including hair restoration, scar treatment, striae management, and wound healing. Furthermore, these biological products can act as adjuvants with other treatment modalities, such as laser therapy, radiofrequency, and microneedling. This review synthesizes the existing evidence, offering insights into the applications and benefits of biological products in aesthetic medicine.
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Fibrina Rica em Plaquetas , Plasma Rico em Plaquetas , Medicina Regenerativa , Humanos , Plasma Rico em Plaquetas/metabolismo , Plasma Rico em Plaquetas/química , Medicina Regenerativa/métodos , Fibrina Rica em Plaquetas/metabolismo , Cicatrização , Plaquetas/metabolismo , Animais , Regeneração , Proliferação de CélulasRESUMO
INTRODUCTION: The study investigates the impact of social media reviews and brand identity on consumer preferences in the non-surgical aesthetics products across different generations. It highlights the evolving landscape of aesthetic medicine and surgery, driven by technological advancements and a cultural shift towards individual well-being. The research aims to explore the interplay between generational preferences, the influence of social media, and the role of brand identity in shaping consumer decisions. METHODS: A cross-sectional study design was employed, with a sample size of > 5000 participants stratified across various generational cohorts. The study utilized an online questionnaire to capture both quantitative and qualitative insights into consumer behaviour, with statistical analysis performed to identify patterns and relationships. RESULTS: Analysis of 5850 responses revealed distinct generational preferences and behaviours. Social media engagement varied significantly across generations, with younger cohorts placing a higher emphasis on online reviews. The study also found that brand identity's influence is diminishing in decision-making processes, with consumers increasingly relying on peer reviews and social media content. CONCLUSION: The findings highlight a pivotal shift in the non-surgical aesthetics consumer market, emphasizing the growing importance of social media and peer reviews over traditional brand identities. Importantly, the study underscores the critical need for integrating patient safety and evidence-based practice within marketing strategies. As consumer preferences evolve towards valuing transparency and authenticity, non-surgical aesthetics providers must prioritize these elements, ensuring that their services are not only appealing but also grounded in safety and scientific validity. LEVEL OF EVIDENCE IV: "This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 ."
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INTRODUCTION: This systematic review delves into the impact of social media on self-perception and the escalating interest in clinical aesthetic procedures, proposing that social media significantly influences beauty standards and increases demand for aesthetic enhancements. METHOD: Following PRISMA guidelines, a mixed-method analysis of 34 articles was conducted, sourced from various databases, focusing on social media's psychological effects on clinical aesthetics decisions. The studies encompassed a broad spectrum, including qualitative, quantitative, and mixed methodologies, reflecting diverse geographical and cultural perspectives. RESULTS: The quantitative analysis demonstrated a strong positive correlation between social media usage and the consideration of aesthetic procedures (r=0.45, p<0.001), indicating a significant impact. Specific findings included a large effect size (Cohen's d=0.8) for the relationship between time spent on social media and the desire for aesthetic enhancements. Individuals spending more than 3 hours per day on social media platforms were twice as likely to consider aesthetic procedures compared to those with less usage, with a 95% confidence interval indicating robustness in these findings. CONCLUSION: Confirming the reinforcing effect of social media on aesthetic decision-making, this study highlights the complex interplay between digital media exposure, altered self-perception, and the increased inclination towards aesthetic procedures. It suggests a critical need for practitioners to carefully navigate the digital influence on patient's desires, reinforcing the significance of understanding psychological motivations and societal pressures in clinical aesthetics. This comprehensive analysis offers pivotal insights for clinical practice and ongoing research into social media's role in contemporary beauty standards. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Estética , Autoimagem , Mídias Sociais , Humanos , Reoperação/psicologia , Reoperação/estatística & dados numéricos , Cirurgia Plástica/psicologia , Feminino , Masculino , Técnicas Cosméticas/psicologia , Procedimentos de Cirurgia Plástica/psicologiaRESUMO
Platelet-rich plasma is an autologous product used in restorative medicine. It contains a high concentration of platelets, which are rich in growth factors and other biologically active substances known for their ability to stimulate regenerative processes in the body. Currently, research is being conducted into the use of platelet-rich plasma in many areas of medicine. This publication provides information on the nature, mechanism of action, therapeutic properties and application of autologous platelet-rich plasma in medicine. Furthermore, ongoing investigations explore its potential in wound healing, orthopedics, dermatology, and even in dentistry, showcasing its versatility and promising outcomes across various medical disciplines. Additionally, the safety and efficacy of platelet-rich plasma therapies are subjects of continual scrutiny, aiming to refine protocols and expand its clinical utility with robust scientific evidence. The growing interest in this regenerative approach underscores its potential as a valuable tool in modern medical practice. Platelet-rich plasma therapy represents a promising avenue for personalized medicine, offering tailored treatment approaches that capitalize on the body's own healing mechanisms to promote tissue repair and regeneration.
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Plasma Rico em Plaquetas , Cicatrização , Humanos , Medicina RegenerativaRESUMO
Dermal filler injectability is a critical factor for commercial product adoption by medical aesthetic professionals and for successful clinical administration. We have previously reported (in vitro and ex vivo) cross-linked hyaluronic acid (HA)-based dermal filler benchmarking in terms of manual and automated injectability requirements. To further enhance the function-oriented product characterization workflows and the clinical relevance of dermal filler injectability assessments, the aim of this study was to perform in vivo evaluations. Therefore, several variants of the MaiLi® product range (OxiFree™ technology) were characterized in vitro and in vivo in terms of injectability attributes, with a focus on hydrogel system homogeneity and ease of injection. Firstly, standardized in vitro assays were performed in SimSkin® cutaneous equivalents, with variations of the clinical injector, injection site, and injection technique. Then, automated injections in SimSkin® cutaneous equivalents were comparatively performed in a texture analysis setup to obtain fine-granulometry injection force profile results. Finally, five female participants were recruited for the in vivo arm of the study (case reports), with variations of the clinical injector, injection site, and injection technique. Generally, the obtained quantitative force values and injection force profiles were critically appraised from a translational viewpoint, based on discussions around the OxiFree™ manufacturing technology and on in-use specialized clinician feedback. Overall, the present study outlined a notable level of homogeneity across the MaiLi® product range in terms of injectability attributes, as well as consistently high ease of administration by medical aesthetic clinicians.