Compact Solid Electrolyte Interface Realization Employing Surface-Modified Fillers for Long-Lasting, High-Performance All-Solid-State Li-Metal Batteries.

The implementation of polymer-based Li-metal batteries is hindered by their low coulombic efficiency and poor cycling stability attributed to continuous electrolyte decomposition. Enhancement of the solid electrolyte interface (SEI) stability is key to mitigating electrolyte decomposition. This study proposes surface-functionalized silica mesoball fillers to fabricate a composite polymer electrolyte (MSBM-CPE). As a result of surface modification, the polyethylene oxide matrix benefits from the uniform distribution of the filler, which provides a large surface area and Lewis acid sites. Molecular dynamics simulations reveal that the dissociation energy of lithium bis(trifluoromethanesulfonyl)imide in the filler is fourfold higher (-1.95 eV) than that of the filler-free electrolyte. Consequently, the MSMB-CPE diffusivity is 30 times higher than its filler-free counterpart. The MSMB-CPE of ionic conductivity of 1.16 × 10-2 S cm-1 @60 °C and a venerable Li-ion transference number of 0.81. The excellent compatibility of MSMB-CPE with the Li anode is demonstrated by its stable symmetric cell performance under high current density (200 µA cm-2 @60 °C) for over 5000 h. Approximately 85.60% retention capacity of the [Li/MSMB-CPE/LiFePO4] full cell after 700 cycles. Furthermore, compositional analysis reveals that the SEI layer in MSMB-CPE is smooth with fewer by-products at the electrolyte/Li interface.

Surface Coordination of Garnet Fillers Improves the Organic-Inorganic Interfacial Compatibility of Composite Solid Electrolyte.

Composite solid electrolytes (CSEs) have become one of the most promising solid-state electrolytes due to their favorable safety and flexibility. However, the weak interaction between inorganic fillers and polymer matrix leads to poor organic-inorganic interfacial compatibility, which degrades the electrochemical performance of CSEs. Herein, it is demonstrated that Li6.4La3Zr1.4Ta0.6O12 (LLZTO) can be chemically bonded to the polymer matrix by surface coordination of the 1,2-dithiolane group of lipoic acid (LA) with metal atoms on the surface of LLZTO through a combination of experimental investigations and theoretical calculations. The surface coordination not only enhances the interfacial compatibility between LLZTO and the polymer matrix, but also facilitates rapid Li+ transport, which leads to the ionic conductivity of the prepared CSE (P-V-M@LLZTO) as high as 6.1 × 10-4 S cm-1 at 30 °C. The excellent interface compatibility ensures a stable cycle of Li/P-V-M@LLZTO/Li symmetrical cell for more than 3500 h. As a result, LiFePO4/P-V-M@LLZTO/Li cell delivers the discharge capacity of 161 mAh g-1 after 5 cycles with a capacity retention of 81% after 500 cycles at 0.5C under 30 °C. This work demonstrates that surface coordination is an effective strategy to solve the inherent interfacial incompatibility problem in CSEs.

A-LLTO Nanoparticles Embedded Composite Solid Polymer Electrolyte for Room Temperature Operational Li-metal Batteries.

Solid-state batteries (SSBs) have the potential to revolutionize the current energy storage sector. A significant portion of the current development of electric vehicles and the electrification of various appliances relies on Lithium (Li)-ion batteries. However, future energy demands will require the development of stronger and more reliable batteries. This report presents a novel solid state electrolyte (SSE) composed of a self-healing composite solid polymer electrolyte (CSPE) matrix and aluminum-doped (Li0.33La0.56)1.005Ti0.99Al0.01O3 (A-LLTO) nanofillers. The CSPE contains Jeffamine ED-2003 monomer, Benzene-1,3,5-tricarbaldehyde (BTC) crosslinker dissolved in a 1:1 ratio of Dimethylformamide (DMF) to LiPF6, and a certain amount (x) of A-LLTO nanofillers (x = 5, 7.5, 10, 12.5%). A CSPE containing x-amount of A-LLTO fillers (referred to as CAL-x%) demonstrates excellent ion-conducting properties and stable battery performance. The CAL-10% demonstrates 1.1 × 10-3 S cm-1 of ionic conductivity at room temperature (RT). A-LLTO nanofillers dispersed uniformly within the polymer matrix form a percolation network, which is believed to improve ionic conductivity and the diffusion of Li+ ions. The CR-2032 cell, consisting of LiFePO4 (LFP)║CAL-10%║Li, at RT offers an initial discharge capacity of ≈165 mAh g-1 at 0.1C rate for 120 cycles with 98.85% coulombic efficiency (C.E.).

PEO-Based Solid Composite Polymer Electrolyte for High Capacity Retention All-Solid-State Lithium Metal Battery.

The limited ionic conductivity at room temperature and the constrained electrochemical window of poly(ethylene oxide) (PEO) pose significant obstacles that hinder its broader utilization in high-energy-density lithium metal batteries. The garnet-type material Li6.4 La3 Zr1.4 Ta0.6 O12 (LLZTO) is recognized as a highly promising active filler for enhancing the performance of PEO-based solid polymer electrolytes (SPEs). However, its performance is still limited by its high interfacial resistance. In this study, a novel hybrid filler-designed SPE is employed to achieve excellent electrochemical performance for both the lithium metal anode and the LiFePO4 cathode. The solid composite membrane containing hybrid fillers achieves a maximum ionic conductivity of 1.9 × 10-4 S cm-1 and a Li+ transference number of 0.67 at 40 °C, respectively. Additionally, the Li/Li symmetric cells demonstrate a smooth and stable process for 2000 h at a current density of 0.1 mA cm-2 . Furthermore, the LiFePO4 /Li battery delivers a high-rate capacity of 159.2 mAh g-1 at 1 C, along with a capacity retention of 95.2% after 400 cycles. These results validate that employing a composite of both active and inactive fillers is an effective strategy for achieving superior performance in all-solid-state lithium metal batteries (ASSLMBs).

In-situ Construction of Poly(tetraisopentyl acrylate) based Gel Polymer Electrolytes with Lix La2-x TiO3 for High Energy Density Lithium-Metal Batteries.

As promising alternatives to liquid electrolytes, polymer electrolytes attract much research interest recently, but their widespread use is limited by the low ionic conductivity. In this study, we use electrostatic spinning to introduce particles of an ionic conductor into polyacrylonitrile (PAN) fibers to prepare a porous membrane as the host of gel polymer electrolytes (GPEs). The relevant in-situ produced GPE performs a high ionic conductivity of 6.0×10-3  S cm-1 , and a high lithium transfer number (tLi + ) of 0.85 at 30 °C, respectively. A symmetrical Li cell with this GPE can cycle stably for 550 h at a current density of 0.5 mA cm-2 . While the capacity retention of the NCM|GPE|Li cell is 79.84 % after 500 cycles at 2 C. Even with an increased cut-off voltage of 4.5 V, the 1st coulomb efficiency reaches 91.58 % with a specific discharge capacity of 213.4 mAh g-1 . This study provides a viable route for the practical application of high energy density lithium metal batteries.

Antiferroelectric AgNbO3 @KH550 Doped PVDF/PMMA Composites with High Energy Storage Performance.

The residual polarization of antiferroelectric ceramics is very small, yet they possess high energy storage density and efficiency. Incorporating antiferroelectric ceramic particles into a polymer matrix is beneficial for improving the energy storage performance of composites. However, excessive amounts of ceramic particles can lead to aggregation within the polymer, resulting in defects and a significant reduction in composite film performance. In this study, the antiferroelectric AgNbO3 is selected as the filler and modified with silane coupling agent KH550. poly(vinylidene fluoride) (PVDF) and polymethyl methacrylate (PMMA) are blended as the matrix, and the energy storage performance of the composite is improved by adjusting the additional amount of PVDF. The structure, dielectric properties, and energy storage properties of the composites are systematically studied. The results show that hydrogen bonds are formed between PVDF and PMMA, and PVDF and PMMA are tightly bonded under the action of hydrogen bonds. The compatibility of PVDF with PMMA is optimal when the mass fraction of PVDF is 30 wt%. Moreover, with the synergistic effect of the antiferroelectric filler AgNbO3 , the breakdown strength of AgNbO3 /PVDF/PMMA composites reaches 430 kV mm-1 , and the energy storage density reaches 14.35 J cm-3 .

Progress on the Sound Absorption of Viscoelastic Damping Porous Polymer Composites.

Porous polymer composites (PPC) have developed rapidly recently, which are widely used in various industrial fields. Viscoelastic damping is an important behavior of porous polymer composites, and it can determine the sound absorption for noise reduction applications. This review has mainly covered the viscoelastic damping and sound absorption of porous polymer composites. Different fabrication approaches of porous polymer composites are gathered. The mechanism of viscoelastic damping behavior is described, and also the sound absorption properties. Followed by the introduction of enhanced sound absorption of viscoelastic damping porous polymer composites, including the incorporation of fillers, microstructures modification, combination with nanofibrous materials, and multilayer configuration, etc. The incorporated fillers can effectively adjust the interfacial area in composites, and obtain desired bonding conditions. Microstructures modification is an effective tool to improve the morphologies of both polymer matrix and fillers, which can be achieved by chemical treatment and surface coating. The combination with lightweight nanofibrous layer can increase the low frequency absorption. The configuration of multilayer composites can improve both acoustical and mechanical properties for engineering applications. It is hoped that this comprehensive review is benefit for the promising development of porous polymer composites in related fields.

LC-OCT as a tool to visualize in vivo location of dermal fillers.

BACKGROUND: Dermal fillers have emerged as a popular non-surgical solution for facial rejuvenation and enhancement. Apart from botulinum toxin injections, they are the most common non-surgical procedure performed in the US. Line-field optical coherence tomography (LC-OCT; deepLive system Damae Medical, France) represents one of the most recent developments in non-invasive skin imaging technologies. MATERIALS AND METHODS: We performed LC-OCT image acquisition on six patients that were treated with hyaluronic acid (HA) dermal fillers in various locations on the face. The images were acquired before the application of the fillers (T0), immediately after (T1), and at a 6- to 8-week (T2) follow-up visit. RESULTS: At T0, we were able to appreciate a normal-appearing epidermis, dermoepithelial junction, and dermis. At T1, the intradermal filler deposits appeared as homogeneously hyporeflective areas, clearly discernible from surrounding vessels and other structures. At T2, the deposits were distinguishable as hyporeflective areas, although they were diminished in size compared to T1. On enface view, collagen fibers had increased thickness and were more homogeneously organized and hyperreflective. CONCLUSIONS: We established the usefulness of LC-OCT in the non-invasive evaluation of dermal HA fillers to visualize both short-term and medium-term effects. LC-OCT may be a valuable tool in evaluating the precise location of filler placement and follow-up of resulting in vivo changes.

Intracorporeal evaluation of hyaluronic acid fillers with varied rheological properties and correlations with aesthetic outcomes.

BACKGROUND: Understanding the differences in soft tissue filler rheology and how these properties can impact clinical results is a fundamental concepts for any injector. This study aimed to assess the tissue integration characteristics of hyaluronic acid (HA) fillers manufactured with different technologies (Non-Animal Stabilized HA [HA-N] or Optimal Balance Technology [HA-O]) using ultra-high-frequency ultrasound. METHODS: Twelve female participants with mild-to-moderate midface volume loss and temporal hollowing were enrolled and treated with HA-N and/or HA-O. Participants were seen at five visits (screening/baseline [treatment], and Weeks 1 [optional touch-up], 4, 6, and 8 [follow-up visits]). Ultrasound was used to evaluate the degree of product integration. RESULTS: On ultrasound, HA-N presented with distinct borders, minimal tissue integration, and a capacity to displace tissues. Conversely, HA-O tended to spread horizontally within the same tissue plane and integrated within tissues. The volumizing capacity of the HA-O fillers was dependent on particle size. CONCLUSION: HA-N is suited for deep injections in areas such as the upper lateral cheek and under the muscle of the temporal region when a lifting effect is desired; HA-O is best suited for subcutaneous injections, in areas of dynamic movement or for patients with thin skin; and can be injected subcutaneously or supraperiosteally when a volumizing effect is desired.

Preparation of CNT/CNF/PDMS/TPU Nanofiber-Based Conductive Films Based on Centrifugal Spinning Method for Strain Sensors.

Flexible conductive films are a key component of strain sensors, and their performance directly affects the overall quality of the sensor. However, existing flexible conductive films struggle to maintain high conductivity while simultaneously ensuring excellent flexibility, hydrophobicity, and corrosion resistance, thereby limiting their use in harsh environments. In this paper, a novel method is proposed to fabricate flexible conductive films via centrifugal spinning to generate thermoplastic polyurethane (TPU) nanofiber substrates by employing carbon nanotubes (CNTs) and carbon nanofibers (CNFs) as conductive fillers. These fillers are anchored to the nanofibers through ultrasonic dispersion and impregnation techniques and subsequently modified with polydimethylsiloxane (PDMS). This study focuses on the effect of different ratios of CNTs to CNFs on the film properties. Research demonstrated that at a 1:1 ratio of CNTs to CNFs, with TPU at a 20% concentration and PDMS solution at 2 wt%, the conductive films crafted from these blended fillers exhibited outstanding performance, characterized by electrical conductivity (31.4 S/m), elongation at break (217.5%), and tensile cycling stability (800 cycles at 20% strain). Furthermore, the nanofiber-based conductive films were tested by attaching them to various human body parts. The tests demonstrated that these films effectively respond to motion changes at the wrist, elbow joints, and chest cavity, underscoring their potential as core components in strain sensors.

Fast Lithium Ion Transport Pathways Constructed by Two-Dimensional Boron Nitride Nanoflakes in Quasi-Solid-State Polymer Electrolyte.

Quasi-solid-state electrolytes (QSSEs) are gaining huge popularity because of their significantly improved safety performance over nonaqueous liquid electrolytes and superior process adaptability over all-solid-state electrolytes. However, because of the existence of liquid molecules, QSSEs typically have low lithium ion transference numbers and compromised thermal stability. In this work, we present the fabrication of a well-rounded QSSE by introducing hexagonal boron nitride nanoflakes (BNNFs) as an inorganic filler in a poly(vinylene carbonate) matrix. BNNFs, in contrast to most inorganic fillers used as anion trappers, are used to build fast lithium ion transport pathways directly on their two-dimensional surfaces. We confirm the attractive coupling between lithium ions and BNNFs, and we confirm that with the help of BNNFs, lithium ions can migrate with less damping and a lower transport energy barrier. As a result, the designed electrolyte exhibits good ion transportability, promoted fire retardancy, and good compatibility with lithium metal anodes and commercial cathodes.

Combination Administration of Heparin and Nitroglycerin for the Treatment of Polycaprolactone-Induced Intravascular Embolism: A Preclinical Investigation.

BACKGROUND: As a new-generation collagen stimulator, polycaprolactone (PCL) containing filler has been extensively applied in facial dermal fillers and other medical aesthetic fields. However, inadvertent intravascular injection of PCL may result in complications such as tissue edema, flap necrosis, and even blindness. To date, there is no effective treatment for PCL-induced intravascular embolism. OBJECTIVES: The aim of this study was to identify a viable resolution for the embolism resulting from intravascular administration of PCL-containing fillers. METHODS: Two different animal experiments were performed: (1) PCL-induced rat inferior epigastric arteries embolism, followed by gross observation, histological evaluation, and cytokines analysis from serum; and (2) PCL-induced rabbit auricular artery embolism, immediately treated with heparin and nitroglycerin. The ears were then evaluated by gross observation, Laser speckle imaging, in vivo imaging system (IVIS) imaging, and histological evaluation. Saline and hyaluronic acids (HA) were used as controls, hyaluronidase was used as a positive drug. RESULTS: In a rat model of inferior epigastric arteries embolism, both intravascular injection of HA and PCL resulted in flap necrosis, indicating that the filler-induced intravascular embolism can lead to serious complications. In a rabbit model of auricular artery embolism, the combination treatment of heparin and nitroglycerin resulted in a relative blood reperfusion recovery of 80% in the ischemic area of the PCL group on day 7 post-operation, which was comparable to that of the HA group treated with hyaluronidase. Histological analysis revealed that the administration of heparin and nitroglycerin significantly attenuated intravascular thrombosis formation and inflammatory cell aggregation. CONCLUSIONS: The combination of heparin and nitroglycerin effectively restores blood flow reperfusion in the intravascular embolization caused by PCL filler injection, alleviates local tissue edema and flap necrosis. These findings offer a novel approach for future clinical management of intravascular embolization with PCL-containing filler injection. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. 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 .

A Cross-Sectional Survey on Pain Management in Dermal Filler Injections from Physicians' and Patients' Perspectives.

BACKGROUND: Hyaluronic acid (HA) dermal fillers injection is a common procedure in patients with cosmetic needs. Concomitant pain is a major complaint among patients undergoing HA filler injections. Relevant research is limited and there is no consensus on pain management of dermal filler injection. OBJECTIVES: To assist physicians in determining a more appropriate treatment approach, and to better provide treatment suggestions. METHODS: A nationwide (China) cross-sectional survey was conducted using questionnaires designed for physicians and patients, respectively. A total of 62 semi-structured questionnaires were administered to aesthetic physicians via face-to-face interview, whereas 123 online-based questionnaires were collected from patients who have ever undergone HA treatment. The collected questionnaire information was analyzed using descriptive statistics and content analysis. RESULTS: 42 (67.74%) physicians observed that over 50% of their patients were concerned about pain during injection. 101 (82.11%) of patients were concerned about impending pain ≥5 points (a total score is 10) before injection. For preferred pain relief modalities, 48 (77.42%) physicians would choose a hyaluronic acid dermal filler with lidocaine, and 82 (66.67%) patients would choose anesthetic-containing products. 59 (95.16%) physicians who injected lidocaine-containing hyaluronic acid found patients had a comfortable treatment experience. CONCLUSIONS: Pain management during hyaluronic acid dermal fillers injection is important from both perspectives of physicians and patients. This survey showed that compared with other analgesic methods, lidocaine-containing hyaluronic acid has offered a more satisfying experience. It also provides insights to physicians and patients in pain management. 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 Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Efficacy and Safety of Fillers for the Treatment of Nasolabial Folds: A Network meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Nasolabial fold formation is increasingly becoming a cause of concern for many people. However, no network meta-analysis has compared the efficacy of different fillers in treating nasolabial folds. This network meta-analysis simultaneously compared the efficacy and safety of various fillers. METHODS: We included randomized controlled trials (RCTs) that used fillers to treat nasolabial folds. We extracted data of Wrinkle Severity Rating Scale (WSRS), Global Esthetic Improvement Scale (GAIS, investigator) scores, GAIS scores (self-reported) and adverse events. RESULTS: We included 13 RCTs. WSRS scores at 6 months were higher in patients receiving HA than those receiving poly (L-lactic acid) (mean difference [MD] 0.630, 95% confidence interval [CI] 0.275, 0.985) but significantly lower in patients receiving HA than in those receiving bovine collagen (MD - 0.580, 95% CI - 0.777, - 0.383) and porcine collagen (MD - 0.525, 95% CI - 0.790, - 0.260). Regarding adverse events, HA was significantly less likely to cause nodule formation compared with bovine collagen (RR 0.593, 95% CI 0.438, 0.803). CONCLUSION: HA is a safe filler for correcting nasolabial folds, and poly (L-lactic acid) showed potential in treating nasolabial folds. LEVEL OF EVIDENCE I: 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 .

Precise Needle and Cannula Placement in the Forehead During Aesthetic Procedures: Can Device and Angulation Influence Accuracy? A Fresh Frozen Specimen Study.

INTRODUCTION: Myomodulation is a technique aimed at enhancing the dynamics of muscle contraction and relaxation through methods like hyaluronic acid (HA) injection. Achieving optimal outcomes depends on the precise placement of the injected product within the targeted anatomical plane. This is particularly important in the forehead, an area with elevated vascular risk. The selected treatment techniques must ensure both efficacy and safety. This study aims to assess the anatomical precision of HA injections in the forehead using different techniques and devices. METHODS: Four fresh frozen specimens were injected with HA by five experienced board-certified plastic surgeons using three different techniques/devices: (1) a 50 mm, 22G microcannula; (2) a 13 mm, 27G needle with the bevel down at a 45-degree angle; and (3) the same needle positioned at a 90-degree angle. Ultrasound analysis was used to evaluate the precision of each approach. RESULTS: Both the cannula technique and the needle technique with the bevel down at a 45-degree angle consistently delivered the filler to the supraperiosteal layer in 100% of cases without spreading. However, the 90-degree needle technique, despite correct placement on the periosteum, resulted in filler dispersion across multiple layers. CONCLUSION: The accuracy of filler placement in the forehead is influenced by the choice of device and its angulation. It is recommended to use a cannula with the entry point at the frontalis crest or a needle angled at 45 degrees to the skin. The use of a needle at a 90-degree angle should be avoided to ensure precise placement and avoid filler migration. NO LEVEL ASSIGNED: 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 .

Treatment of Atrophy of the Labia Majora: Calcium Hydroxyapatite or Hyaluronic Acid?

PURPOSE: The study aimed to evaluate and compare the efficacy and safety of treating atrophied labia majora with hyaluronic acid (HA) and calcium hydroxyapatite (CaHA). METHODS: Ten participants complaining of sagging or loss of volume in the labia majora were evaluated and randomly assigned to two groups-treated with CaHA or AH. Photographic documentation was taken and appreciated by the participants and by blind observers. RESULTS: The study showed an improvement in labia majora regarding volumization and flaccidity that was more significant after 90 days of treatment in both treatments. Besides flaccidity, volume replacement resulted in better balance and proportion between the labia majora and labia minora. The evaluators, independent and blind, judged that in 80% of the cases of the HA group and in 50% of cases of the CaHA group, there was an excellent improvement. CONCLUSION: CaHA and HA are both effective and safe for treating the intimate region, and this study cannot prove the superiority of one over the other. An appropriate assessment involving the analysis of sagging and/or volume loss and the creation of a sequential treatment protocol, involving CaHA and HA, seems to be the best solution. LEVEL OF EVIDENCE I: Evidence obtained from at least one properly designed randomized controlled trial. 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 .

Updated Filler Emergency Kit: Next-Generation Emergency Solution.

INTRODUCTION: The rising popularity of facial filler injections has corresponded with an increase in reported complications. While a filler emergency kit was previously introduced, advancements in the field have highlighted certain limitations, prompting the development of the updated filler emergency kit (UFEK). METHODS: The authors conducted literature research up to February 2023, focusing on PubMed and open web searches for articles referred to filler emergent complications: vascular occlusion, blindness and anaphylaxis. Approximately 1200 articles were obtained from PubMed and other sources, and 45 articles were reviewed. RESULTS: The developed UFEK protocol delineates specific interventions meticulously tailored to address diverse emergent scenarios linked to soft tissue fillers complications. This protocol emphasizes the urgent requirement for timely and personalized interventions. CONCLUSION: The UFEK offers a standardized, comprehensive and effective approach. This work contributes to the responsible and informed progression of the field of aesthetic medicine, providing more value and safety, both for clinicians and 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 .

New Aesthetic Unit (NAU) Method: A Comprehensive Method Based on Accurate Anatomical Assessment and Precise Multilayering Panfacial Treatment for Hyaluronic Acid Fillers.

BACKGROUND: Recent progress in anatomy enables a more sophisticated approach to treat patients with facial aesthetic concerns (PFAC) with HA fillers. Furthermore, advances in rheology have offered a range of HA fillers with different biomechanical properties adapted to different indications. METHODS: Based on recent anatomical and rheological progresses, the author has developed a new methodology that couples an accurate patient assessment tool and a panfacial precise treatment instrument. In the presented method, the face is divided into 6 units called New Aesthetic Units (NAU). NAUs are classified on the extent of volume deficiency and asymmetry, ranging from none to moderate to severe deficiencies. After discussion with the patient regarding the assessment findings, a customized treatment plan, including timelines and number of sessions, is recommended. The modalities of the treatment are exhaustively described for each NAU based on multilayering, best practice medicine, and expert consensus available in the literature. RESULTS: Before-and after-case studies are presented to illustrate how the NAU method is used in routine practice for the treatment of two patients with HA fillers. CONCLUSION: The NAU method is not only a practical and accurate roadmap for the assessment and treatment of PFAC with HA fillers, but also facilitates communication between injectors and patients and data analysis. 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 .

Cross-linked Sodium Hyaluronate Gel with PLLA-b-PEG Microsphere for Facial Contouring in Chinese: A Retrospective Study.

BACKGROUND: In Asia, the demand for cosmetic facial treatments has surged due to technological advancements, increased social acceptability, and affordability. Poly-L-lactic acid (PLLA) fillers, known for their biocompatibility and biodegradability, have emerged as a popular choice for facial contouring, yet studies specifically addressing their use in Asian populations are scarce. METHODS: This retrospective study examined 30 Chinese patients who underwent facial contouring with PLLA fillers, focusing on product composition, injection techniques, and safety measures. A comprehensive clinical evaluation was performed, including the Global Aesthetic Improvement Scale (GAIS) and Global Impression of Change Scale (GICS) for effectiveness and patient satisfaction, respectively. RESULTS: No significant difference in GAIS scores was observed between injectors and blinded evaluators over a 12-month period, indicating consistent effectiveness. Patient satisfaction remained high, with GICS scores reflecting positive outcomes. The safety profile was favorable, with no serious adverse events reported. The study highlighted the importance of anatomical knowledge to avoid complications, particularly in areas prone to blindness. CONCLUSIONS: PLLA fillers offer a safe, effective option for facial contour correction in the Asian population, achieving high patient satisfaction and maintaining results over time. The study underscores the need for tailored approaches in cosmetic procedures for Asians, considering their unique facial structures and aesthetic goals. Further research with larger, multicenter cohorts is recommended to validate these findings and explore long-term effects. 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 .

Safety and Efficacy of Diluted Calcium Hydroxylapatite for the Treatment of Cellulite Dimpling on the Buttocks: Results from an Open-Label, Investigator-Initiated, Single-Center, Prospective Clinical Study.

BACKGROUND: Cellulite is a condition characterized by dimpling and contour irregularities in the gluteal and thigh regions, affecting an estimated 80-98% of postpubertal women. Innovative treatments for cellulite dimpling in the buttocks have gained popularity in recent years, seeking new solutions for a historically challenging condition. In this open-label, investigator-initiated, single-center, prospective clinical study, the authors sought to evaluate the safety and efficacy of diluted calcium hydroxylapatite (CaHA; Radiesse®, Merz Aesthetics, Raleigh, NC) for the treatment of cellulite dimpling in the buttocks of adult women. METHODS: Subjects underwent three treatment sessions, receiving a total of 12 syringes of 1:1 diluted CaHA administered using a cannula-based subcision technique. Endpoints included the cellulite severity scale (CSS), the global aesthetic improvement scale (GAIS), subject satisfaction measured on a 5-point scale, and three-dimensional imaging analysis via the Quantificare 3D Track®. RESULTS: Twenty-four subjects completed the study (mean age, 35 years; mean BMI, 26.88 kg/m2; mean body fat percentage, 31.29%), and no serious complications were reported. Quantitative analysis at week 14 revealed a mean reduction of 54.0% in the number of visible dimples and 50.09% in dimple depth compared to baseline. The mean CSS score decreased by 4.29 points, representing a 43.92% improvement in cellulite severity from baseline (p < 0.0001). Both physician-assessed and subject-assessed GAIS ratings also demonstrated significant improvement, with 91.6% of subjects rating their cellulite appearance as "improved" or greater. CONCLUSION: The results of this study support the safety and efficacy of diluted CaHA for treating cellulite dimpling in adult women. LEVEL OF EVIDENCE II: 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 . CLINICAL TRIALS REGISTRATION: This study is registered with clinicaltrials.gov (ID: NCT05885035) and can be found at this link: https://clinicaltrials.gov/study/NCT05885035 .