Facial Rejuvenation Treatment Research Articles

Safety Profile of Thread Lifts on the Face and Neck: An Evidence-Based Systematic Review.

"Thread lifting" has quickly gained popularity as a minimally invasive treatment for facial rejuvenation. However, the effectiveness is questionable, and the safety and adverse effects are often not discussed. To identify and discuss the adverse effects associated with various types of threads. Studies describing the use of thread lifts were identified using a PubMed search. Inclusion criteria included studies in which barbed and nonbarbed threads were used for the face and neck. Fifty-nine articles consisting of 14,222 patients (14,134 barbed, 81 nonbarbed, and 7 combined cases) were included. The most common side effects overall were facial asymmetry (n = 6,143), edema/tumefaction (n = 453), and ecchymosis (n = 407). Serious adverse effects were rare and consisted of paresthesias, alopecia, and injuries to vessels/glands. Most adverse effects were transient and self-resolving, with the exception of contour irregularities, injuries to vessels/glands, infections, and inflammatory reactions. Most side effects associated with threads were self-resolving, whereas more serious cases subsided with treatment. Future studies are critical to further determine whether thread lifting provides long-lasting, safe, and satisfying results.

Absorbable Barbed Threads for Lower Facial Soft-Tissue Repositioning in Asians.

IntroductionAsian patients often seek to address lower facial aging through clinical interventions that increase anterior projection and jawline contouring. The Definisse™ (also known as Happy Lift™) thread lift treatment uses barbed absorbable threads to suspend tissues and induce biostimulation. We evaluated the efficacy and safety of absorbable barbed threads for lower facial reshaping in Thai patients.MethodsThis prospective, evaluator-blinded study enrolled 27 Thai patients diagnosed with mild to moderate facial laxity. Patients underwent thread implantation along the mandibular angle with one of two double needle thread lengths (12 and 23 cm) to create a “J stitch”. Primary outcome was the clinical improvement in facial laxity as graded by two blinded dermatologists at baseline, immediately after treatment, and at 1 week and 1, 2, 3, 6, and 12 months follow-up. Objective measurements included volume in the jawline, nasolabial folds, and submental area. Patients’ self-assessment scores and adverse reactions were recorded.ResultsOf the 27 patients recruited to the study, 25 (92.6%) attended all follow-up visits. Clinical improvement of facial laxity was observed immediately after thread implantation. There was significant volume improvement in the jawline, nasolabial folds and submental area at almost all follow-up visits (p < 0.007), with most patients (51.9%) reporting excellent lifting effect as early as the 1 week follow-up visit. All adverse reactions were mild and resolved spontaneously without any medical intervention.ConclusionImplantation of absorbable barbed threads is a safe and effective treatment for facial rejuvenation in Thai patients. Long threads (23 cm) showed a slight superiority to short threads (12 cm) in terms of face-lifting efficacy, which suggests the benefit of additional barbs in tissue suspension and biostimulation. The disadvantage of absorbable threads is that their visible lifting effects are not as long-lasting as those of non-absorbable ones, since they are reabsorbed from 6 months onwards.Trial registrationClinicalTrials.gov identifier: TCTR20210415001. This clinical trial was retrospectively registered 12 April 2021.

Peeling with 25% trichloroacetic acid in the treatment of facial skin photoaging

Introduction: The chemical peel consists of the application of chemical exfoliants that eliminate the layers of the skin so that it can regenerate with an improved texture and pigmentation. It is currently a valuable therapy in dermatology, however, few studies objectively evaluate its efficacy. Objective: To evaluate the efficacy and safety of peeling with 25% trichloroacetic acid in the treatment of facial skin rejuvenation. Method: An observational, analytical and longitudinal study was carried out in 250 patients from two hospitals (Surgical Clinic: “Hermanos Ameijeiras” and General Teaching: “Enrique Cabrera”), in the period between January 2010 and January 2020. Treatment It was applied monthly for 6 months. The final evaluation was carried out 3 months after the end of the treatment. Results: 238 women and 12 men were treated with an average age of 30.5 (± 8.4) years. After treatment, there were significant changes in the Glogau Photo Damage Scale (P=0.012), in the Lemperle Wrinkle Assessment Scale (P=0.016) and in the Global Aesthetic Improvement Scale (P=0.021). The adverse events found were burning, inflammation and scaling. The degree of satisfaction reported by the patients was good (4.4%) and very good (95.6%) (P=0.011). Conclusion: The 25% trichloroacetic acid peel proved to be effective and safe to reduce the signs of facial skin aging, associated with a high degree of patient satisfaction.

Peeling with 30% Salicylic acid in the treatment of facial skin photoaging

Introduction: Chemical peeling consists of the application of one or more chemical ablative agents to the surface of the skin to induce keratolysis or keratocoagulation, with subsequent regeneration, achieving improved texture and pigmentation. It is currently a popular tool in the dermatology therapeutic arsenal, however, few studies objectively evaluate its efficacy. Objective: To evaluate the efficacy and safety of the 30% salicylic acid peeling in the treatment of facial skin rejuvenation. Method: An observational, analytical and longitudinal study was carried out in 280 patients from two hospitals (Surgical Clinic: “Hermanos Ameijeiras” and General Teaching: “Enrique Cabrera”), in the period between January 2010 and January 2020. Treatment It was applied monthly for 6 months. The final evaluation was carried out 3 months after the end of the treatment. Results: 256 women and 24 men were treated with an average age of 34.2 (± 6.3) years. After treatment, there were significant changes in the Glogau Photo Damage Scale (P = 0.015), in the Global Aesthetic Improvement Scale (P = 0.023) and in the Lemperle Wrinkle Assessment Scale (P = 0.017). The adverse events found were burning, inflammation and scaling. The degree of satisfaction reported by the patients was good (6.4%) and very good (93.5%) (P = 0.001). Conclusions: The 30% salicylic acid peel proved to be effective and safe to reduce the signs of facial skin aging, associated with a high degree of patient satisfaction.

Combined press cog type and cog PDO threads in comparison with the cog PDO threads in facial rejuvenation.

Thread lifting is one of the most common minimally invasive options in facial rejuvenation procedures. The application of polydioxanone (PDO) showed good results and fewer complications. PDO threads effectively strengthen the contour of the face, reduce roundness, and lift sagging skin due to collagen-stimulating properties. The purpose of this study was an evaluation of the efficacy of the PDO threads: the combination of the cog type and press cog type threads (Ncog and Nfix) and cog type thread (Ncog) alone. And this study was conducted to define complications related to thread inserting during the follow-up period. Thirty patients who underwent PDO thread treatment for facial rejuvenation and tightening sagging skin tissues were evaluated. The follow-up period was seven months. Photographic objective and subjective evaluations were performed during this period. Thirty patients were included in this study. The mean age of participants was 51.8years (range 65 to 34). There was a statistically significant difference between pre and 1-month post-operative results in both groups with a mean score of 1.94±0.43 (p<0.05). Furthermore, the combination of Ncog and N fix showed slightly better results than Ncog alone. According to patient satisfaction, all patients were satisfied with the clinical outcomes. Our results revealed PDO threads are effective in aged skin rejuvenation, soft tissue retraction, and support, showing fewer complications. In addition, it could be assumed that treatment with thicker thread could be a more efficacious procedure. However, this statement requires further researches.

Anatomy and Aging of the Perioral Region.

Perioral region, although severely impacted by facial aging, is often overlooked in texts on facial rejuvenation. Sun exposure, bone resorption, dynamic contraction of the sphincteric and nonsphincteric oral musculature, gravitational pull, histological changes of the skin, and unhealthy habits all take their toll in this area. Fine wrinkling on the lips, deep nasolabial and mentolabial folds, elongation and flattening of the upper lip, downturned corners of the mouth, marionette lines, diminished vermillion and upper teeth show and chin irregularities are the main signs of this process, raising great concern amongst patients and making the perioral region the most demanded area for facial rejuvenation treatment. A huge armamentarium of surgical and nonsurgical techniques, with or without complex technology, are available to tailor patient's specific needs, from chemodenervation and mild chemical peels to operations designed to restore the size and shape of the lips. In this article we perform a comprehensive review of the contemporary treatment of the aging perioral area, detailing the most common techniques and their nuances.

Protocolo para rejuvenescimento facial minimamente invasivo em idosos

Objetivo: relatar o caso clínico de tratamento de rejuvenescimento facial em paciente idosa por meio da indução percutânea de colágeno, uso de fios de polidioxanona (PDO), preenchimento com ácido hialurônico e aplicação de toxina botulínica. Esses procedimentos são minimamente invasivos, utilizados para amenizar as alterações faciais decorrentes do envelhecimento. Descrição do Caso: paciente de 76 anos, apresentou interesse por procedimentos estéticos faciais e os mesmos foram realizados sequencialmente, conforme o plano de tratamento. Iniciou-se com microagulhamento seguida da máscara de ácido retinóico e orientações de home care. Após 28 dias, foi realizada aplicação de 50U de toxina botulínica no terço superior da face, nos músculos prócero (6u), corrugadores de supercílio (8u), frontal (14u), orbicular dos olhos (18u) e nasal (6u). Seguido um mês, foi realizada a inserção de 8 fios de PDO no terço médio da face para lifiting facial, e após mais 30 dias a paciente foi submetida a aplicação de ácido hialurônico para preenchimento labial, de olheiras, região malar/zigomático e de bossa canina. Após 6 meses da realização da toxina botulínica, uma nova aplicação de 50U foi realizada nas mesmas regiões aplicadas anteriormente. Todos os procedimentos foram bem sucedidos e proporcionaram bem estar e rejuvenescimento para a paciente. Conclusão: os procedimentos estéticos sequenciais propostos restabeleceram características de jovialidade e resultaram em bem estar físico e emocional, repercutindo na melhora na qualidade de vida da paciente.&#x0D;

Fractional 1064 nm Picosecond Laser in Treatment of Melasma and Skin Rejuvenation in Asians, A Prospective Study.

Facial melasma is a disfiguring pigmentation and occurs frequently with aging skin. Topical treatment alone was often suboptimal. A recent study showed that fractional picosecond laser has promising result in benign pigmentary lesions. This study aims to investigate the efficacy and safety of 1064 nm picosecond laser in treatment of facial melasma and skin rejuvenation in Asian skin. Patients of Asian descent seeking treatment for facial melasma and skin rejuvenation were screened and recruited. Each patient received up to nine laser treatments at 4-6 weeks intervals with a fractionated nonablative 1064 nm picosecond laser. Baseline and posttreatment modified Melasma Area Severity Index (mMASI) and Global Aesthetic Improvement Scale (IGAS) were assessed by blinded investigators based on the clinical photographs. Subject overall satisfaction was assessed by the questionnaires after treatment. All adverse events were documented. Twenty patients were recruited with a median age of 52.7 ± 8.2 years. Three subjects had Fitzpatrick skin type III and 17 had skin type IV. All subjects received nine laser sessions. Over 70% of patients were satisfied with the treatment outcomes. There was a statistically significant improvement in mMASI which reduced from 10.8 at baseline to 2.7 and 3.6 at 6 and 12 weeks post-treatment, respectively (both P < 0.01). For skin rejuvenation, 70% reported at least a moderate improvement at 6 weeks of post-treatment. No major side-effect was reported. Erythema was the most frequent transient response, while some reported edema (1.1%). Both resolved spontaneously. None reported hypo- or hyperpigmentation after treatment. The overall mean pain scare (VAS) was 1.92. Fractionated non-ablative 1064 nm picosecond laser was effective in treatment of melasma and skin rejuvenation. It was also safe and well tolerated. Importantly, there was no hypo or hyperpigmentation reported. Lasers Surg. Med. 00:00-00, 2021. © 2021 Wiley Periodicals LLC.

Synergistic Effects of Autologous Platelet-Rich Plasma and Hyaluronic Acid Injections on Facial Skin Rejuvenation.

Many therapeutic options are currently available for facial skin rejuvenation, but little evidence exists about the efficacy of combining such procedures. The aim of this study was to assess and investigate the synergistic effect of hyaluronic acid (HA) and autologous platelet-rich plasma (a-PRP) injections on facial skin rejuvenation. For this randomized controlled prospective study, 93 eligible patients were enrolled and randomized into 3 intervention groups to undergo a series of 3 treatment sessions with either a-PRP, HA, or a mixture of a-PRP and HA (Cellular Matrix; Regen Lab) injected into facial cheeks. A total of 93 patients were included. Treatment with Cellular Matrix led to a very significant improvement in the overall facial appearance compared with treatment with a-PRP or HA alone (P < 0.0001). Participants treated with Cellular Matrix showed a 20%, 24%, and 17% increase in FACE-Q score at 1, 3, and 6 months posttreatment, respectively. For the HA group, the improvement in FACE-Q score was 12%, 11%, and 6% at 1, 3, and 6 months posttreatment, respectively, whereas for the a-PRP group the improvement was 9%, 11%, and 8% at 1, 3, and 6 months posttreatment, respectively. Biophysical measurements showed significantly improved skin elasticity for the Cellular Matrix group compared with the groups receiving a-PRP or HA alone. No serious adverse events were reported. Combining a-PRP and HA seems to be a promising treatment for facial rejuvenation with a highly significant improvement in facial appearance and skin elasticity compared with a-PRP or HA alone.

1540‐nm fractional erbium: Glass laser is a safe and effective modality for nonablative facial rejuvenation

Laser treatments for facial rejuvenation are common, with ablative modalities being of more common use for this indication. Efficient nonablative modalities are of rising demand. Our aim was to determine the safety and efficacy of high-fluence, nonablative 1540-nm fractional Erbium:glass laser for facial rejuvenation. A retrospective study of patients treated with 3-4 treatments using the 1540-nm fractional Erbium:glass laser for facial rejuvenation, using 2500-3000mJ/stacked pulses (51-61mJ per pixel). Patients were followed-up for 3months following their last treatment. Before and after photos were independently blindly evaluated by 2 dermatologists, who graded them using a scale from 0 (exacerbation) to 4 (76%-100% improvement) for 2 different facial regions (frontal face region and lateral canthal region). Pain perception and adverse effects as well as patient satisfaction were documented throughout the study. Sixteen patients completed both treatment and follow-up period. At the 3-months posttreatment follow-up visit, moderate-to-significant improvement in rhytids appearance (mean grade of improvement: 2.93 for frontal face and 3 for lateral canthal region) was observed. Patients' satisfaction was high (4.25). Patients reported mild and transient erythema posttreatment with no other adverse effects. The high-fluence 1540-nm fractional Erbium:glass laser is a safe and effective nonablative modality for facial rejuvenation.

Platelet-Rich Plasma: Evolving Role in Plastic Surgery

The use of platelet-rich plasma has emerged as one of the most desired nonsurgical treatments for facial rejuvenation and hair restoration. It has grown to encompass a wide variety of applications within the field of plastic surgery, including its use in combination with microneedling, laser, and fat-grafting procedures. In this article, the authors aim to (1) describe the preparation process of platelet-rich plasma; (2) discuss the proposed science behind platelet-rich plasma with regard to its evolving role in hair restoration and facial rejuvenation; and (3) highlight the recent literature examining its widespread use. Based on the available literature, there is a therapeutic advantage to the use of platelet-rich plasma as a single treatment modality for alopecia and skin rejuvenation and in combination with laser skin treatment and fat grafting. There is, however, a considerable amount of variability in the processing, preparation, and treatment modalities. Despite a lack of standardized protocols for platelet-rich plasma preparation and a scarcity of large-scale studies with long-term follow-up, there is convincing evidence with objective measurement modalities that display positive outcomes after treatment for skin rejuvenation, hair regrowth, wound healing, and fat graft take.

Analysis of the Columellar-Labial Angle in Perioral Aging.

The young face presents a convex and rounded aspect; with aging, this changes to a more concave and flattened aspect, with the angles of the face undergoing changes through soft tissue repositioning and bone remodeling. The columellar-labial angle is one of the features that change. The objective of the present study was to analyze the columellar-labial angle at different stages of adult life and assess its contribution to facial changes during aging. We analyzed a database (December 2017-March 2018) of 722 female patients, aged 21 to 88 years, and obtained anthropometric measurements of the columellar-labial angle with a Canfield Vectra 3D image analysis system. Our database originates from a private clinic where all patients were registered and photographed. Our analysis showed a decrease in the columellar-labial angle, mainly observed from patients aged 60 years and older. This decrease can be explained by the absorption of body structures that occurs during aging. The columellar-labial angle decreases with age, and this finding may provide a better understanding of the transformation that occurs with aging. Obtaining a clearer view of the changes that occur in the face will improve treatments for facial rejuvenation, either conservative or surgical, and provide a basis for future studies and knowledge expansion.

At-home Cosmeceutical Application and Outpatient Treatments: A 3D Stepwise Facial Rejuvenation Approach

BACKGROUND: Aging affects the 3-dimensional structure of all the facial tissues: Bones, muscles, ligaments, adipose tissue, and skin.&#x0D; AIM: To customize minimally invasive treatments for facial rejuvenation, we present a standardized holistic approach characterized by at-home treatments in associations with outpatient procedures.&#x0D; METHODS: Forty-four patients underwent 3-dimensional stepwise facial rejuvenation and were evaluated prospectively. Each patient received a customized treatment plan based on a clinical examination and consultation. Treatment outcomes were evaluated from patient photographs with and skin analysis was performed with an A-One Smart automated skin analysis system.&#x0D; RESULTS: The mean age of the patients was 41.7 years and the approximate mean duration of treatment was 160 days. Patients applied cosmeceuticals such as retinoic acid. Outpatient procedures included the delivery of botulinum toxin or dermal fillers, thread lifting, chemical peels, etc. Upon treatment completion, significant improvements were noted in multiple domains: Skin elasticity and hydration increased, areas of hyper-pigmentation were less extensive, and there were fewer visible wrinkles and pores.&#x0D; CONCLUSION: Outcomes of the present article suggest how important is to customize facial anti-aging treatments. Nonsurgical treatments carried out progressively, involving the patient to perform at-home treatments in associations with outpatient procedures, let to achieve facial improvements in terms of increased skin elasticity and hydration, reduction of hyperpigmentation, wrinkles, and pores.

Musclerelaxant Local Injection as an Useful Test Before Botulinum Toxin a Treatment for Facial Rejuvenation

Musclerelaxant Local Injection as an Useful Test Before Botulinum Toxin a Treatment for Facial Rejuvenation

Enhanced Pulsed Dye Laser for Facial Rejuvenation.

To evaluate the efficacy of an enhanced pulsed dye laser (PDL) for treatment of facial-dyschromia. Thirteen patients were enrolled in the study. Nine patients were female, four were male, with a mean age of 61 years. All patients presented with either facial telangiectasia, rosacea, pigment, or a combination thereof. At the initial evaluation, test spots were performed to determine the subject's response to selected treatment parameters. In the study, the enhanced 595 nm PDL deployed a spot size range of 5-12 mm with fluences ranging from 8 to 18 J/cm2 . Pulse duration was 10 milliseconds. Enhancements in this device included the option for contact or cryogen spray cooling, increased maximum pulse energy, increased repetition rate, option for addition of radiofrequency (RF), an option for a 15 mm spot size, and longer dye life. The smaller spots were used only for focal low contrast pigmented lesions that persisted after overall facial treatment with the larger spot. Smaller fluences were applied for general rejuvenation with the 12 mm spot (mean ~9 J/cm2 ). Sapphire contact cooling was applied at 10°C. A smaller area of the skin was reserved (typically pre-auricular area) for addition of RF energy just before the pulse (40-70 J/cm3 ) over 100 milliseconds with a 20 milliseconds delay between the end of the RF pulse and beginning of the laser pulse. The minimum fluence that achieved vessel closure/vessel bluing and/or slight immediate pigment darkening was applied based on test spots performed just before treatment to the entire face. Determinations of improvement were made by evaluation of photographs with standard settings using polarized and nonpolarized images. Up to three treatments were performed approximately 1 month apart with follow-up visits 1 and 3 months after the final treatment. Evaluation by a panel of blind observers determined a mean clearance of at least 50% in all lesions, while 77% of lesions had 50-75% clearance, and 23% of lesions had 76-100% clearance. Pain was approximately 4/10. Subjective lesion improvement and satisfaction rates were 3 out of 4 and 3.6 out 4, respectively. An enhanced PDL is effective in one pass treatments for facial rejuvenation with considerably less operative time than previous commercially available systems. A second pass applied to focal challenging lesions results in even more improvement, in a single treatment session. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.

Ultrasound assessment of tissue integration of the crosslinked hyaluronic acid filler VYC-25L in facial lower-third aesthetic treatment: A prospective multicenter study.

BackgroundDermal fillers have become an integral part of any aesthetic physician's intervention.AimsTo assess, by means of ultrasounds, the tissue integration of the hyaluronic acid (HA) dermal filler VYC‐25L in chin and jaw.MethodsProspective, noncomparative, open‐label, and multicenter study conducted on healthy subjects, with age comprised between 30 and 60 years old, who attended to the clinic to perform a facial rejuvenation treatment of the lower third of the face. VYC‐25L was injected using a 27G needle (supraperiosteal bolus, from 0.2 to 0.3 mL per bolus) in the chin and with canula (retrograde threads, from 0.4 to 0.6 mL) in the jaw. Ultrasound examinations (UE) were performed at each study center by the same experienced observer at baseline, immediately after injection, 48 hours, and 30 days after treatment.ResultsThirty patients (10 per center) were included in the study. At baseline, UE found a characteristic heterogeneous pattern of subcutaneous cellular tissue, with alternation of soft anechoic and hyperechoic images. The UE, performed immediately after treatment, showed a poorly defined globular ultrasound pattern, with anechoic images indicative of liquid content. Forty‐eight hours after treatment, UE are still showing a globular pattern, with well‐defined anechoic areas. Thirty days after treatment, a thickening of the subcutaneous cellular tissue was observed in all the evaluated zones, with a total integration of the HA into the tissue.ConclusionVYC‐25L might represent a significant advance in volumization/restoration of the lower face. Its biointegration was total at day 30 and practically complete at 48 hours of treatment.

Efficacy of home-use light-emitting diode device at 637 and 854-nm for facial rejuvenation: A split-face pilot study.

The use of light-emitting diode (LED) in combination wavelength for facial rejuvenation has been previously reported. Nowadays, there has been a growing market for home-use cosmetic devices because of its low cost and convenience. To evaluate the efficacy and safety of home-use LED device on facial rejuvenation. This was a prospective split-face clinical trial with a total of 24 subjects, who presented with photo aging skin. All subjects were treated with the home-use LED device on the left side of their face, twice a week for 8weeks. Primary outcomes measured in the study were the changes in the biophysical properties of the skin assessed with the following parameters: skin elasticity, skin hydration, texture, and wrinkles. Evaluations were done at baseline, 2-, 4-, 6-, and 8-week follow-up. Subjects' self-improvement scores and adverse reactions were also recorded. All 24 subjects completed the study and attended all follow-up. Skin elasticity was significantly higher in the LED group compared to the control during the 6- and 8-week follow-up (P<.05). In the LED group, an image of the treated skin captured using Visioscan® showed improvement of the skin texture at 8-week follow-up. Majority of the subjects in the LED group scored good improvement on all follow-ups (37.5%, 41.7%, 58.3%, and 62.5%) when compared to the baseline. No adverse reactions or pain were recorded in the study. The home-use LED device, with a combination wavelength of 637 and 854nm, is safe and can be used as an adjunctive treatment for self-administered facial rejuvenation.

Manual therapy in the treatment of facial wrinkles and sagging: a quantitative-qualitative randomized clinical trial

Background: Manual therapy has emerged as an option for facial rejuvenation treatment due to its effects on connective tissue. Objectives: The aim of the study was to verify the effectiveness of the manual therapy protocol in attenuating wrinkles and facial sagging. Methods: This is a quantitative-qualitative, randomized clinical trial. The study included female volunteers, aged between 40 and 50 years, distributed in 2 groups: Manual therapy group (MTG) and Control group (CG). The protocol used consisted of: lymph node decongestion, sliding massages, fast and vigorous movements, and traction on the fasciae. The evaluation instrument was through photos, in which they were analyzed by Dermato-functional specialists through a scale that graduates the wrinkles. The Shapiro-Wilk normality test was used to analyze the symmetry of the results by the Gauss curve. Pre- and post-intervention differences between the groups were determined using the non-parametric Wilcoxon test. Results: The average score obtained in the graduation of wrinkles and signs of aging in the manual therapy group showed significant differences in all regions of the face before and after treatment. And there was a decrease in the score, which shows improvement in the reduction of wrinkles and signs of aging, especially in the upper third. In contrast, in the control group, the average remained before and after the follow-up by the research, showing that there were no significant changes in this group. Conclusion: The manual therapy protocol showed significant results in reducing the signs of aging, such as fine lines and wrinkles, being another option to be applied in clinics.

Commentary on Retention Rates Among Patients Undergoing Multimodal Facial Rejuvenation Treatment Versus a Single Monotherapy in Cosmetic Dermatology Practices.

Commentary on Retention Rates Among Patients Undergoing Multimodal Facial Rejuvenation Treatment Versus a Single Monotherapy in Cosmetic Dermatology Practices.

Retention Rates Among Patients Undergoing Multimodal Facial Rejuvenation Treatment Versus a Single Monotherapy in Cosmetic Dermatology Practices

Facial aging is a multifactorial process. Accordingly, expert opinion has largely been unanimous in that multimodal treatment targeting various aspects of the aging face provides superior results. However, there is a lack of studies exploring patient response. To compare patient retention between triple multimodal facial rejuvenation treatment (neuromodulator, filler, and energy-based therapy) and monotherapy (neuromodulator alone). A retrospective, multicenter (the United States, Canada, and Germany) study was performed. Cases were retrieved from July 2015 to June 2016. The study compared patients who had undergone monotherapy (neuromodulator), combined multimodal treatment (neuromodulator, filler, and energy-based therapy on the same day), and sequential multimodal treatment (neuromodulator, filler, and energy-based therapy over a 1-year period). Retention rates were calculated. A total of 509 patients were included: monotherapy (300), sequential multimodal treatment (93), and combined multimodal treatment (116). Patient retention was significantly higher in the combined multimodal treatment group compared with the monotherapy and sequential multimodal treatment groups (p < .001). Subgroup analysis revealed similar trends at all sites. Based on retention rates, patients are more likely to return to the clinic when multiple treatment modalities are used during 1 encounter. These data further solidify the importance of multimodal therapy for both the provider and the patient.