Facial Rejuvenation Treatment Research Articles

Evidence-Based Medicine for Nonsurgical Facial Rejuvenation.

Options for nonsurgical facial rejuvenation treatment have increased significantly in both availability and popularity over the past two decades. However, there remains a paucity of clinical practice guidelines and evidence-based recommendations for these procedures. The purpose of this article is to assess the presence of current high-level research for various methods of nonsurgical facial rejuvenation using the Oxford Centre for Evidence-Based Medicine. Botulinum toxin injections remain the best-studied method, with several randomized controlled trials guiding recommendations for safety and efficacy. Several studies on injectable fillers document complications and recommendations to avoid these, but sample sizes are small and many are noncomparative. Deoxycholic acid has been well examined and Food and Drug Administration approved to address submental fat but has not been studied in other areas of the face. Although chemical peels, laser skin resurfacing, energy-based facial rejuvenation, microneedling, and platelet-rich plasma have a variety of facial rejuvenation applications with minimal side effect profiles, there is significant variability with treatment protocols, outcomes measures, and randomized controlled trials with extended follow-up to develop clinical practice guidelines.

Buccal Fat Pad Excision for Facial Rejuvenation: The Relationship Between the Resected Position and Its Influence on Facial Shape and Volume.

To date, facelift surgery has been the most common choice for those seeking antiaging solutions. However, buccal fat pad (BFP) excision has also been utilized recently. An interrelation between the BFP, resection area, and its influence on facial shape and volume is scrutinized to achieve "tailor-made" outcomes in patients with BFP-related symptoms. Patients were categorized into 2 groups: Type I with a bottom-heavy face and Type II with ptotic lower cheeks, typically seen in older people. The lower face was divided into upper and lower segments bilaterally. Then, the relationship between the resected position of the BFP and its influence on facial shape and volume was studied. BFP excision was performed for 133 patients (118 females and15 males) between May 2020 and June 2022. Sixty-one of these patients were categorized into Type I (39 patients) and Type II (22 patients) and were followed up for 12 months postoperatively. The volume of all lower facial segments decreased postoperatively in both types of patients. The variation rate of the upper segment volume in Type II patients was less than that in Type I patients. The results were consistent with a technique that did not remove large chunks of the BFP from the upper segment in Type II patients. BFP excision is an effective facial rejuvenation treatment if proper candidates are selected. To improve the accuracy of BFP excision, the relationship between the resected position of the BFP and its influence on facial shape and volume should be well understood.

Assessment of the efficacy and safety of platelet rich plasma gel injection in facial rejuvenation and wrinkles

Background: Changes in the three-dimensional geometry of the underlying structures contribute to the ageing process of the human face, just as the skin's surface textural wrinkling does. Objective: To evaluate the efficacy and safety of platelet rich plasma gel injection in facial rejuvenation and facial wrinkles. Methods: This study was carried out on 10 subjects presented by facial wrinkles. Patients were subjected to platelet rich plasma gel injection after taking an informed consent. They were assessed clinically by global assessment scale before treatment and at the end of follow up period. Results: After administration of plasma gel, all subjects significantly improved clinically immediately. This finding confirmed by significant improvement of global assessment scale. Conclusions: Plasma gel seem to be safe, effective and well tolerated in treatment of facial wrinkles and rejuvenation.

The Comparison of Platelet‐Rich Plasma Versus Injectable Platelet Rich Fibrin in Facial Skin Rejuvenation

Background/Objective. Platelet‐rich plasma (PRP) has a widespread use in various indications including dermatological conditions. Injectable platelet‐rich fibrin on the other hand is prepared without anticoagulants and seems to have a sustained action. This study aimed to compare PRP and PRF injection treatments for facial skin rejuvenation in terms of efficacy, patient satisfaction, and side effects. Patients and Methods. Patients who received facial intradermal injections of PRP or PRF for skin rejuvenation were included in this study. Patients received three injections one month apart and evaluated at follow‐up visits for cosmetic results using a high‐resolution UVA‐light video camera and a surface evaluation software at three regions (frontal, nasolabial, and canthal) as well as for patient satisfaction and side effects. Results. A significant marginal superiority of PRF over PRP was only evident for some canthal cosmetic parameters (canthal smoothness and wrinkles); however, the two groups did not differ in terms of other cosmetic regional parameters. For canthal smoothness, the difference was significant at three months. The two groups did not differ in terms of side effects, pain, and patient satisfaction. Conclusion. This study obtained slightly better outcomes with PRF injections when compared to PRP for facial rejuvenation only at canthal region and only at three months, which disappeared later during the treatment. PRF may represent a viable alternative to PRP for that indication owing to its easier preparation, absence of anticoagulants, and possibly its sustained effect. Further large studies are warranted.

Forehead lifting with hyaluronic acid filling: A new technique called ‘Crown Lift’

AbstractBackgroundThe forehead is an important region to be evaluated in the treatment of facial rejuvenation and knowledge of techniques, the anatomy of the region and aesthetic norms are essential for patient treatment. The present study aims to demonstrate a new filling technique with hyaluronic acid for elevation and lifting effect of the entire forehead region, repositioning and rising the eyebrow with satisfactory and lasting results.MethodsA prospective, 30‐day follow‐up, open‐label, quasi‐experimental (before‐after) single‐centre study was conducted with 10 patients.ResultsThe new technique support the frontal musculature, in its upper portion, producing a lifting effect of the entire frontal region, repositioning and elevating the eyebrow.ConclusionAnalysis of the vectors provided by the comparison of D0 and D30 images revealed a significant lifting effect on the face corroborating with the results of GAIS and PGAIS.

OZONE AS A COLLAGEN BIO-STIMULATOR

The search for a skin similar to that obtained through filters of social networking applications is increasingly present in the complaints and desires of patients who arrive at the office. As the skin is the organ that most reflects the effects of the passage of time, in addition to genetic factors, hormonal status and metabolic reactions, such as oxidative stress, your health and appearance are directly related to the eating habits and the chosen lifestyle. The current challenge is the search for minimally invasive facial rejuvenation treatments with a lower risk of complications. A clinical case was reported in this article using only ozone applied subcutaneously to the submental region and neck. Clinical case: patient I.V, female, 60 years old, sought a private practice complaining of sagging skin in the papillae and neck region that bothered her. After careful examination and skin evaluation, it was proposed to the patient that we start the collagen induction protocol with ozone. Thus, we can conclude that the use of this aforementioned technique is an excellent alternative (safe and effective) for a more youthful and rejuvenated skin.

Clinical Observation of Botulinum Toxin Type A Combined with Nanofat in Facial Rejuvenation Treatment

Objective: To investigate the efficacy of botulinum toxin type A combined with nanofat in the treatment of facial rejuvenation. Methods: from January 2020 to January 2021, 20 patients with facial wrinkles in our hospital (The First Affiliated Hospital of Dalian Medical University) were treated with botulinum toxin type A combined with nanofat, and the effect, duration and complications were observed. Results: After 1, 3 and 6 months of injection, the effective rates were 90%, 75% and 40%, respectively; there was no occurrence of postoperative infection, fat mass, granuloma, and other adverse reactions. Conclusion: Botulinum toxin type A combined with nanofat filling has a clear therapeutic effect in the facial rejuvenation treatment, and can improve the skin texture while improving wrinkles, which is worthy of further popularization and application in clinic.

Microliposuction and radiofrequency combined with the thread technique as a new method used in lower face lifting.

Minimally invasive facial rejuvenation is a popular and well-established treatment for patients seeking facial lifting. The authors combined facial microliposuction, radiofrequency, and thread lifting technology as a comprehensive treatment (LRT) for facial rejuvenation in a case series of 57 patients. A total of 76 patients underwent surgery and 75% completed 6months of follow-up (57 patients); the patients were aged 26 to 51 (33.6 ± 4.5) years. All patients were followed up for hematoma within 1week after the operation and for skin numbness and muscle paralysis at 1week and 3months postoperatively. Patient satisfaction with the postoperative aesthetic effects was analyzed by Face-Q™ at 6months after the operation. The score for hematoma within 1week was 1.21 ± 0.33, scores for postoperative skin numbness within 1week and 3months were 2.06 ± 0.51 and 1.17 ± 0.32, respectively, and scores for postoperative muscle paralysis within 1week and 3months were 1.31 ± 0.55 and 1.00 ± 0, respectively. Fifty-seven patients completed Face-Q™ (score: 22.1 ± 1.8, standard score: 82.2 ± 14.8). LRT is a minimally invasive method that can achieve a synergistic and satisfactory result for patients with mild to moderate facial skin sagging.

Efficacy and safety of 755-nm picosecond alexandrite laser with topical tranexamic acid versus laser monotherapy for melasma and facial rejuvenation: a multicenter, randomized, double-blinded, split-face study in Chinese patients.

To compare the efficacy and safety of 755-nm picosecond alexandrite laser and topical tranexamic acid (TTA) combination therapy with laser monotherapy, for the treatment of melasma and facial rejuvenation. This multicenter, randomized, double-blinded, split-face study enrolled 37 patients who presented with melasma and photoaging. Facial halves were randomized to receive either laser and TTA combination therapy or laser monotherapy. Three treatments were delivered at 4-5weeks intervals. Patients were followed up for 1, 3, and 6months post-final treatment and evaluated by blinded investigators for hemi-Melasma Area and Severity Index (hemi-MASI), facial dyschromia, skin texture, laxity, and rhytids. Daily diaries rating healing progress for 7days posttreatment and satisfaction grading were performed by all patients. Adverse events were recorded. Thirty-six patients completed the follow-up. Compared with the baseline, hemi-MASI, dyschromia, and skin texture on both halves improved significantly through the follow-up (p = 0.000). A significant difference in hemi-MASI and dyschromia between combination therapy halves and monotherapy halves was noticed at 1- and 3-month follow-ups (p < 0.05). The laser monotherapy halves displayed significantly less redness and sensitivity during the 7-day posttreatment recovery period (p < 0.05). Patients' satisfaction ratings for the combination therapy halves were higher than the monotherapy halves at 1-month follow-up (p < 0.05). No severe adverse events were observed. The picosecond alexandrite laser and TTA combination therapy demonstrated synergistic efficacy for hemi-MASI and dyschromia improvements over laser monotherapy. The optimization of the picosecond laser and TTA combination regimen needs further investigation.

The Overfilled Face.

The desire for longevity, beauty, and health is as old as the history of human culture. Minimizing tissue damage and invasive surgeries has led to a variety of options in the 21st century medicine. In the past 20 years, hyaluronic acid filler injections have thus become a popular modality of treatment for facial rejuvenation due to low costs for patients with immediately visible results. Ideally, the treated face looks natural. We aim at stopping time, maybe tweaking the handles of our clocks a bit backward to counteract aging processes, but creating a natural look and maintaining the individual appearance.

Evaluation of the efficacy and safety of the 1064 nm picosecond Nd:YAG laser with a topically applied gold and diamond suspension for facial skin rejuvenation: A pilot study.

To investigate the efficacy and safety of combined treatment with a serum comprising a micro-diamond suspension and micro-gold cage with a 1064 nm picosecond neodymium-doped yttrium aluminum garnet (Nd:YAG) laser for facial skin rejuvenation. Topical serum was applied to the entire face and allowed to penetrate the skin and hair follicles for 20 min. Each participant was then treated with a 1064 nm picosecond Nd:YAG laser on the face. Photographs of each participant were taken at baseline, immediately after treatment, and 2 weeks after treatment using an imaging tool (Mark-Vu®; PSI PLUS, Suwon, Republic of Korea). Global improvement scores by two blinded investigators and participants' satisfaction scores were also assessed. The melanin index (MI), transepidermal water loss (TEWL), and skin hydration were evaluated using a device. Parameters associated with skin rejuvenation were assessed using Mark-Vu®. Adverse events were observed and reported by participants and physicians during the treatment and follow-up visit. At week 2, 40% (4/10) of the participants showed more than moderate clinical improvement in the investigator's global improvement assessment. No significant differences were observed in the MI, TEWL, skin hydration level, or skin parameters of Mark-Vu®. At week 2, 40% of the participants reported a high satisfaction score and minimal side effects. The novel topical facial serum comprising micro-diamond suspension and micro-gold cage is safe and effective when combined with laser treatment for facial rejuvenation.

Puzzle Facelift: A Nonsurgical, Whole Treatment for Facial Modeling and Rejuvenation.

The assessment of correct anatomy of face and the evaluation of the dynamic interplay between anatomy and function, to get an overall improvement, is a leading topic in aesthetic surgery and has increased its impact in recent years. A nonsurgical impact technique reduces both post-treatment discomfort and the overall cost. Obtaining the simultaneous correction in forehead, nose, lips, and chin means obtaining an overall improvement in face view. Likewise, the high predictability of the procedure and the absence of alloplastic implant, bone re-absorption, and scars have to be considered in nonsurgical aesthetic medicine. In conclusion, a single session of profile correction using hyaluronic acid filler should be proposed to patients, every time the aesthetic practitioner sees a coexistence of forehead, nose lips, and chin defects.

Facial rejuvenation treatments: a clinical review of botulinum toxin A, microneedling, hyaluronic acid dermal filler and intense pulsed light

Facial rejuvenation treatments include any injectables or skin interventions that make the face appear younger. This article aims to improve treatment outcomes by assisting practitioners in selecting optimum treatment for patients depending on their individual needs, whether that is wrinkle reduction, long-term improvement of skin elasticity, reduction in pigmentation, tightening or all of these. This review includes clinical analyses of botulinum toxin, microneedling, hyaluronic acid dermal filler and intense pulsed light, including evidence and arguments for the benefits and limitations in each case.

Quantified Facial Rejuvenation Utilizing High Intense Focus Ultrasound with Multiple Penetrative Depths

BackgroundMultiple penetration depths of high-intensity focused ultrasound (HIFU) treatment for facial rejuvenation have not been quantified.MethodsWe enrolled 12 participants (n=24) to undergo one session of HIFU rejuvenation between January 1, 2019, and January 10, 2020. We used a 2-, 4.5-, and 6-mm focal depth transducer on the upper and middle face. We evaluated efficacy on days 60 and 90 by using our specific assessment system.ResultsThe average eyebrow peak and pupil–eyebrow peak angles significantly increased by 2° (p < 0.0005) and decreased by 1° (p < 0.0001), respectively, at day 90. The shortened eyebrow–iris length indicated that the forehead tissues had lifted and moved medially to the central face. Supraorbital tissues were also vertically elevated, marked by the eyebrow–orbital (p = 0.0016) and vertical palpebral fissure lengths (p = 0.0052), which both exhibited a 0.8-cm elevation. For the midface, the increased canthus–oral–nasal angle (p = 0.5881) and decreased tragus–oral length (p = 0.5881) indicated that laxity had been corrected through lifted oral commissure, though the data were not statistically significant. No serious side effects were observed.ConclusionHIFU treatment with multiple depths quantitatively improved both upper-facial rejuvenation and midface rejuvenation after a single session.

Visual loss after aesthetic facial filler injection: a literature review on an ophthalmologic issue.

Dermal filler injection is among facial rejuvenation treatments that have been increasingly used. Despite being a minimally invasive procedure, it can lead to severe complications such as blindness. A review of all cases of filler- -induced visual loss in the world literature was conducted to summarize the mechanisms, anatomical considerations, and clinical ophthalmologic course, current strategies of prevention and management, and trends over the years. We identified 233 cases of filler-induced visual loss, and 172 patients had a severe visual impairment in at least one eye. The typical patients are young women who received injections of hyaluronic acid or autologous fat in the glabella or nose, and the typical presentations were sudden ocular pain, ptosis, and ophthalmoplegia due to vascular occlusion. The findings of this study also suggest an increase in the number of unlicensed professionals performing the procedure. Even though the continued development of dermal fillers has improved the treatment options available, further studies and strategies are necessary to reduce the incidence and minimize the consequences of filler-induced visual loss.

Ischemic complications of dermal fillers

Dermal fillers have become increasingly popular as a cosmetic treatment for facial rejuvenation. Although these injections are generally considered to be safe, as the number of injections has increased, so has the rate of complications. Ischemic complications of fillers is critical and include vision loss, ophthalmoplegia, skin necrosis, and cerebral infarction. Knowing the anatomy well to optimally prevent and manage these serious complications. Prevention includes knowledge of the vascular anatomy of the facial area, as well as certain injection techniques such as aspiration, use of a smaller needle, and adoption of a larger cannula. The use of ultrasound has been a recent innovation in preventing and treating filler complications as well. The reversibility of fillers should also be considered when choosing a filler. Some hyaluronic acid (HA) fillers, including the newer ones on the market, are difficult to reverse and non-HA fillers and fat are irreversible. This review aims to discuss facial anatomy, the various ischemic filler complications, the prevention and management of these complications, and the relatively recent use of imaging as an adjunct.

Radiofrequency in Facial Rejuvenation

Abstract Rhytides and striae are prominent clinical signs of skin aging. Photoaging, characterized by a thinning epidermis and a decrease in collagens, is the main form of skin aging. Delaying the aging process is a concerning issue for dermatologists. Radiofrequency (RF) is a non-ablative technology used for skin rejuvenation, body contouring, and weight reduction. The selective electro-thermolysis stimulates collagen contraction and neocollagenesis. Compared to traditional cosmetic treatment, it has the advantages of fewer side effects and short patient downtime. This review aims to summarize the efficacy and safety of different RF devices and the limitations during RF treatments. Combinations of RF and other cosmetic technologies are demonstrated. Results have been approving for the various uses of RF, including skin laxity and wrinkles smoothening. However, many studies use subjective ways of evaluation. Further studies are needed to determine the optimization of RF treatments for facial rejuvenation.

Efficacy of Low-temperature Plasma for Treatment of Facial Rejuvenation in Asian Population.

Background:Plasma, the fourth state of matter, has been widely proposed in antiaging medicine. The usage of low-temperature plasma (LTP), which converts nitrogen gas into plasma, demonstrates releasing of several growth factors and promotion of tissue regeneration. The nonchromophore-dependent property and preservation of skin architecture after treatment make LTP an interesting tool for facial rejuvenation. This study aimed to investigate the efficacy of LTP for facial rejuvenation.Methods:A prospective cohort study involving 40 women who received full face LTP treatment once a week for 5 consecutive sessions. The melanin index, erythema index, and elasticity index were measured by Mexameter and Cutometer, respectively. The Fitzpatrick wrinkle scale and quartile grading scale were assessed by two plastic surgeons.Results:All patients were between 26 and 55 years old and had mild-to-moderate Fitzpatrick wrinkle scale scores. The Fitzpatrick wrinkle scale scores showed a mean improvement of 0.47 and 0.89 at 4 and 12 weeks posttreatment (P < 0.001). Statistically significant improvements in melanin index, erythema index, and elasticity index at periorbital and perioral areas were found at 4 and 12 weeks after treatment (P < 0.001). Most subjects had quartile grading scale improvement of 51%–75% at 4 and 12 weeks after treatment. Patients reported a greater than 75% improvement in dyspigmentation, wrinkles, and elasticity in 60%, 50%, and 57.5% of subjects, respectively.Conclusion:LTP is another choice for facial rejuvenation, wrinkles reduction, and dyspigmentation with significantly improved results.

A study of intradermotherapy with needles in facial rejuvenation

Background:Intradermotherapy is considered a minimally invasive procedure, which works through applications of diluted pharmacological drugs, resulting in facial rejuvenation.Methods:18 women were divided equally into two groups and evaluated before and after treatment (at 45 and 90 days). Four applications were made to the facial region at 15-day intervals; for group 1, traditional injections were given to introduce the anti-ageing substance, and, for group 2, a placebo intervention (0.9% saline application) was given.Results:In the analysis of the group 1 photos, greater filling of the nasogenian groove was observed after two sessions, and the presence of less deep wrinkles in the perioral area was also observed after four treatment sessions. Subjects in both groups complained of pain during the application, even with the use of anaesthetic. Most of the volunteers in group 1 said that the texture of the skin seemed much firmer and classified the therapy as an ‘excellent treatment’.Conclusion:Intradermotherapy shows favourable results in the treatment of facial rejuvenation in women, which is more evident 90 days after the initial application.

Efficacy of Erbium-Doped Yttrium Aluminium Garnet 2,940 and 1,064 nm Laser Treatment for Facial Rejuvenation-A Randomized Controlled Split-Face Clinical Trial.

The 2,940 nm erbium-doped yttrium aluminium garnet and 1,064 nm neodymium-doped yttrium aluminium garnet lasers have been widely applied in facial rejuvenation, but no randomized trials exist to evaluate the efficacy of the combination treatment. The efficacy of the combined treatment for facial rejuvenation. A total of 20 subjects with facial aging were enrolled and randomly assigned into 2 groups: one side of the face was treated with a 2,940 nm or 1,064 nm laser alone and the other side was treated with the combined lasers. The patients were treated by 3 sessions with 1-month intervals. The efficacies were quantitatively accessed by digitalized high-resolution photographs. The 1,064 nm laser alone showed significant improvements on indexes of skin texture, spore, brown spots, elasticity, and melanin as compared with the baseline (p < .05). The 2,940 nm laser alone showed significant improvements on indexes of wrinkle, texture, pore, and elasticity (p < .05). The combined treatments showed significant improvements on the abovementioned indexes as compared with either a 1,064 nm or 2,940 nm laser treatment (p < .05). A combination of 1,064 nm and 2,940 nm laser treatment renders significantly better efficacies for facial rejuvenation as compared with a 2,940 nm or 1,064 nm laser alone.