Autologous blood-derived extracellular vesicles (EVs) have gained attention as a novel therapeutic approach for skin rejuvenation. This study evaluates their efficacy in improving wrinkles, lifting, hydration, barrier function, tone, radiance, texture, and pore size in human subjects. This study aimed to evaluate the clinical efficacy of a single intradermal injection of autologous blood-derived EVs in improving multiple skin parameters, including wrinkle reduction, skin lifting, hydration, barrier function, tone, radiance, texture, and pore size, over a three-week period. Twenty-five participants aged 40-59 underwent a single facial injection of autologous blood-derived EVs. Evaluations were conducted before treatment, 5 days post-treatment, and 3 weeks post-treatment using objective skin analysis tools and subjective self-assessment questionnaires. Statistically significant improvements (p < 0.05) were observed in wrinkle depth, skin lifting, hydration, elasticity, and barrier function at both 5-day and 3-week time points. Skin tone, radiance, texture, and pore size also improved significantly over the study period. Subjective self-assessments corroborated the instrumental findings, with a marked increase in participant-reported satisfaction. No adverse reactions or safety concerns were reported during the study. This study demonstrates the clinical efficacy and safety of autologous blood-derived EVs in facial rejuvenation, supporting their potential as a non-invasive cosmetic treatment.

Bone and Fat Pad Restoration Using CMC Combined with HA: Innovative Approaches in Facial Rejuvenation

Introduction. Multiple conceptual approaches exist for understanding facial aging, with a primary focus on either skin changes, volume fluctuations, gravitational changes in soft tissues, or facial skeletal atrophy. Many techniques following the concepts of aging are often used and promoted by the authors as universal. However, different individuals age differently, and therefore a differentiated approach to the choice of technique is logical. Each patient represents a unique combination of treatment objectives that are associated not only with the initial physical characteristics of the patient, but also with their subjective self-perception. The search for classifications or algorithms that could provide guidance for tactics remains relevant. Purpose of the study: to improve the planning of surgical correction of age-related changes in the face. Material and methods. The study was carried out by analyzing existing concepts of age-related changes in the face and approaches to the selection of surgical correction tactics. Results. The analysis of the literature showed that the classifications and assessment systems developed to date are not objective, given the diversity of facial structures, national characteristics, and subjective views on facial aesthetics. The main result of our work was the development of a surgical strategy based on identifying the individual needs of patients. It has been established that neither the presence nor the severity of certain signs of aging can determine the tactics. The correct approach is to determine the clinical significance of certain age-related changes in the face and, on this basis, to subordinate the options for surgical correction techniques (choice of incision line, detachment option, vectors of tissue movement and fixation, volumetric maneuvers) for each specific clinical situation individually. The algorithm for choosing a technique should be based on solving specific problems posed by a given patient. Each objective should correspond to its own technique, which may vary from person to person in the same area. Conclusions. Aging is fragmentary and can be described by individual signs. Each sign corresponds to a specific objective for the surgeon. Surgeons tend to objectify the severity of signs (visual manifestations), although this is unreliable. The relevance of the signs (the significance for the patient) does not necessarily correlate with the severity, i.e. cannot and does not require to be objectified. Essential is not the quantification of severity, but the presence of a symptom (indication for surgical intervention, i.e., the objective) and the improvement resulting from achieving the objective, i.e., patient satisfaction. The correction of the same facial area in patients with different types of age-related changes can be approached in different ways and depends on individual needs. The tactics for surgical facial rejuvenation should be based on solving specific tasks set by the patient. Введение. Существует много концептуальных подходов к пониманию старения лица, где главенствующая роль отдается либо изменениям кожи, либо колебаниям объема, либо гравитационным изменениям мягких тканей, а также атрофии лицевого скелета. Многие методики, следующие за концепциями старения, зачастую применяются и пропагандируются авторами как универсальные. Однако различные лица стареют по-разному, в связи с чем логичен дифференцированный подход к выбору методики. Каждый пациент представляет собой новую комбинацию лечебных задач, которые связаны не только с исходными физическими характеристиками пациента, но и с его субъективным самовосприятием Актуален поиск классификаций или алгоритмов, которые могли бы служить определителями тактики. Цель исследования: улучшение планирования хирургической коррекции возрастных изменений лица. Материал и методы. Исследование выполнено путем анализа существующих концепций возрастных изменений лица и подходов к выбору тактики хирургической коррекции. Результаты. Проведенный анализ литературы показал, что разработанные до настоящего времени классификации и системы оценок не являются объективными, учитывая многообразие вариантов строения лица, национальных особенностей, субъективных взглядов на эстетику лица. Основным результатом нашей работы явилась выработка хирургической стратегии, основанной на выявлении индивидуальных потребностей пациентов. Установлено, что ни факт наличия, ни степень выраженности тех или иных признаков старения не являются определителями тактики. Правильным подходом является определение клинической значимости тех или иных возрастных изменений лица и на этой основе субординирование вариантов хирургических техник коррекции (выбор линии разреза, вариант отслойки, векторы перемещения и фиксации тканей, волюметрические маневры) для каждой конкретной клинической ситуации индивидуально. Алгоритм выбора методики должен строиться на решении конкретных задач, поставленных данным пациентом. Каждой задаче должна соответствовать своя техника, на разных лицах в одной и той же зоне она бывает разной. Заключение. Старение фрагментарно и может быть описано отдельными признаками. Каждый признак соответствует отдельной задаче хирурга. Выраженность признаков (визуальных проявлений) хирурги в силу привычки стремятся объективизировать, хотя это ненадежно. Актуальность признаков (значение для пациента) не обязательно пропорциональна выраженности, т.е. объективизации не поддается, да и не требует ее. Важна не оцифровка степени выраженности, а, во-первых, факт наличия признака (показания к хирургическому маневру, т.е. задача) и, во-вторых, факт улучшения в результате решения задачи, т.е. удовлетворенность пациента. Задачи коррекции одной и той же зоны лица у пациентов с разным типом возрастных изменений могут решаться различным образом и зависят от индивидуальных потребностей. Тактика при хирургическом омоложении лица должна строиться на решении конкретных задач, поставленных пациентом.

Purpose:Facial aging, marked by soft tissue atrophy, ptosis, and midfacial structural changes, has amplified the role of dermal fillers in modern aesthetic practice. The bilaminar injection technique leverages the distinct rheological properties of high and low G prime hyaluronic acid fillers to enable dual-plane facial rejuvenation—deep structural support and superficial contour refinement. This case series investigates the clinical efficacy and safety of this technique in correcting tear trough deformities.Methods:The study was conducted in a single-center institutional aesthetic setting. Five patients (aged 25–60 years) presenting with midface volume loss and tear trough concerns for both the eyes were included following clinical assessment. Randomization and masking were not applied due to the nature of the procedure. A bilaminar approach was adopted: high G prime fillers were injected supraperiosteally to reinforce & augment deep structures, while low G prime fillers were deposited subdermally for fine contouring. All procedures were performed under aseptic conditions using a combination of needle and cannula techniques.Results:Primary outcomes included periorbital volume restoration and contour correction assessed at a 2-week follow-up. Adverse events and patient satisfaction (measured via visual analog scale) were also documented for 3-6 months. All patients exhibited visible improvement in midface volume and tear trough contour, with high satisfaction scores. Transient ecchymosis and edema were the only noted minor side effects.Conclusion:The bilaminar technique offers a precise, anatomically harmonious, and well-tolerated approach to tear trough rejuvenation, establishing itself as a sophisticated tool in advanced facial aesthetics.

Background: The evolution of facelift techniques reflects the ongoing search for natural, durable and reproducible facial rejuvenation. While deep-plane and extended- Superficial Musculoaponeurotic System (SMAS) approaches offer comprehensive results, they require wide dissection and recovery. Conversely, short-scar and mini-lift techniques minimize incisions but may lack true deep support. Objective: To describe the U-Lift, a hybrid technique combining limited periauricular access with deep-plane dissection and SMAS fixation. Methods: A U-shaped incision around the ear allows elevation to the pre-parotideal fascia. Three main PDS 3-0 fixation sutures are placed at the lower conchal, preauricular and postauricular points. Complementary 4-0 Polydioxanone Suture (PDS) close the deep layer and a continuous 5-0 mononylon suture closes the skin. Results: The technique provides effective lower face and cervical rejuvenation through minimal incisions, with low morbidity and rapid recovery. Conclusion: The U-Lift achieves natural rejuvenation by integrating true SMAS suspension with short-scar access, bridging the gap between mini and deep-plane facelifts.

Thread lifting has become widely adopted worldwide as a nonsurgical facial rejuvenation technique due to its simplicity and short recovery period. However, despite its generally favorable safety profile, various complications may occur, with pseudoaneurysms being extremely rare. Herein, we present a case of iatrogenic superficial temporal artery pseudoaneurysm (STAP) following facial thread lifting. A 60-year-old woman developed a soft pulsatile mass in the temporal region 2 months after undergoing a thread lift at a cosmetic clinic. She was referred to our hospital, where STAP was diagnosed. The pseudoaneurysm was completely excised, and the patient recovered uneventfully without recurrence. While STAP most commonly occurs after trauma, it may also arise from head and facial surgeries or injections. Surgical excision is generally considered the treatment of choice, although embolization or conservative management may be appropriate in selected cases. To minimize complications, physicians performing thread lifting should undergo adequate training and pay close attention to the anatomy of the face and neck during the procedure.

ABSTRACTBackgroundThe rising popularity of injectable soft‐tissue fillers in esthetic medicine is driven by their potential to provide facial rejuvenation through minimally invasive techniques. Hyaluronic acid (HA)‐based fillers exhibit distinct biophysical characteristics, including rheological properties which are critical for their behavior under mechanical stress. This study aims to compare the viscoelastic properties of commercially available crosslinked (CFs) and non‐crosslinked HA fillers (NCFs).MethodsA total of 28 commercially available HA fillers, including both non‐cross‐linked (n = 3) and cross‐linked types (n = 25), were investigated for their rheological properties. Rheological parameters such as storage modulus (G′), loss modulus (G″), loss tangent (tan δ), and complex modulus (G*) were measured over a frequency range of 0.1–10 Hz.ResultsNCFs showed greater variation in G′ with a mean of 3263% [range: 1767–4177] compared to crosslinked fillers with 247.60% [range: 85–720]. The calculated difference between the change in percent of CFs versus NCFs was 3016% (755) for G′ with p < 0.001, whereas it was 926% (498) for G″ with p < 0.001, and it was −154% (25.8) for tan‐delta with p < 0.001, and 966% (147) for G* with p < 0.001.ConclusionsNCFs and CFs exhibit distinct rheological profiles, with NCFs demonstrating a greater change in their initial rheologic properties when exposed to mechanical stress. This specific biophysical behavior (increase in stiffness and viscosity) predisposes NCFs for dermal structural support with the respective subdermal applications, whereas CFs seem to be more suitable for deep soft tissue injections, offering volumization.

Objective: To conduct a preliminary survey on the demand for the application of facial rejuvenation thread-embedding therapy in Traditional Medicine among patients and Traditional Medicine physicians at Can Tho Traditional Medicine Hospital. Methods: A cross-sectional descriptive study was performed on 385 patients and 30 Traditional Medicine physicians at Can Tho Traditional Medicine Hospital from November 2023 to May 2024. Data were collected using a structured questionnaire based on the Health Belief Model (HBM) and analyzed with SPSS version 20.0. Results: A total of 65.7% of patients and 86.7% of Traditional Medicine physicians expressed demand for facial rejuvenation thread-embedding therapy. Patients mainly valued the method's safety (54.5%) and rejuvenation effectiveness (73.8%), while the primary barrier was the high treatment cost (29.7%). For physicians, the primary barrier was the lack of specialized training (100%), although most were confident and willing to implement the method if provided with adequate professional support. Conclusion: Both patients and Traditional Medicine physicians perceive facial rejuvenation thread-embedding therapy as a feasible and valuable technique for health enhancement and aesthetic care in Traditional Medicine. Further efforts should focus on technical training, procedural standardization, and interventional clinical studies to promote broader community implementation.

This study aimed to evaluate the efficacy and biocompatibility of various absorbable threads from Hans BioMed for facial lifting in a Sprague Dawley rat model, focusing on collagen production, inflammatory responses, and overall skin remodeling. Six types of absorbable threads, PCL, PDO, PDLLA, PLCL, and two P4HB variants (55 and 90% elongation) from Hans BioMed, were analyzed using histological, immunohistochemical, and molecular methods for observation, including 1, 2, 4, and 8weeks post-thread insertion. Total 140 rats were used with 20 rats for each thread group, in which five rats for each time point. Firstly, inflammatory markers, including TNF-α and IL-6, peaked at 1week and subsided significantly by 8weeks, confirming the safety profile of all threads. The overall results demonstrated that all threads induced collagen formation and reduced inflammation over time. Notably, collagen 1 levels in all testing groups steadily increased from 2 to 8weeks, complemented by reduced metalloproteinase expression, indicating preserved collagen stability, observed in Western Blotting. Additionally, RT-PCR highlighted increased expression of collagen-related genes and elevated TGF-β and α-SMA levels, suggesting enhanced skin remodeling capabilities. All tested absorbable threads promoted collagen formation and showed minimal response to inflammation over time. The findings provide a foundation for developing advanced thread-lifting products, offering improved skin elasticity, firmness, and collagen synthesis outcomes. 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 https://link.springer.com/journal/00266 .

To investigate the changes in the location of the modiolus, a fibromuscular structure between the orbicularis oris and lip dilator muscles, with aging in Asian individuals. The position of the modiolus was evaluated using ultrasound imaging in 45 young (20s) and 45 elderly (80s) Asian participants of both sexes. A statistically significant (p<0.05) downward and inward shift in the location of the modiolus was observed with aging. The aging process is associated with laxity of the lip elevator muscles and increased contracture of the lip depressor muscles, as indicated by the changes in modiolus position. These findings may have implications for facial rejuvenation procedures.

Conventional facelift surgery may fail to adequately address submandibular gland ptosis (SMGP), prompting recommendations for partial gland resection. Alternatively, the extended SMAS technique involves a more extensive SMAS-platysma dissection, providing lower facial and neck rejuvenation while preserving the submandibular glands. This study aims to quantify the effect of the extended SMAS technique on SMGP. This retrospective cohort study analyzed 53 patients who underwent extended SMAS facelift surgery over a 10-year period in the senior author's practice. Photographic analysis was used to quantify SMGP correction and cervicomental angle (CMA) improvement. All patients were available at a mean follow-up of 8.4 months (range: 1-34 months). Mean SMGP decreased from 8.9 mm preoperatively (range: 0-23 mm) to 0.1 mm postoperatively (range: 0-3.9 mm), with an average improvement of 8.01 mm (P < 0.001). The mean CMA improved from 152° (range: 100-180°) to 121° (range: 92-156°), with a mean change of 30.8° (P < 0.001). Two patients (3.8%) were dissatisfied, and 3 (5.7%) required office revisions. The extended SMAS facelift technique effectively controls SMGP, nearly eliminating submandibular gland visibility on postoperative photographic analysis while enhancing neck angularity. This improvement may result from the thorough release of the cervical and parotid retaining ligaments as well as the platysma-auricular ligament. This level of SMAS-platysma flap mobilization may have a more effective sling-like effect on the contents of the digastric triangle, potentially obviating the need for submandibular gland resection.

Non-surgical mandibular contouring has gained attention as a safe and effective approach to improve jawline aesthetics and restore lower facial definition. This study aimed to assess the efficacy, safety, and patient satisfaction associated with an anatomically guided hyaluronic acid (HA) filler technique designed to enhance chin projection and mandibular contour using minimal product volume. Ten healthy patients aged 25-45 years underwent individualized treatments guided by facial proportions and anatomical landmarks. A maximum of 6 mL of high elastic modulus (G′) HA filler was administered per patient. Three-dimensional photographic documentation and ultrasound imaging were used to guide applications and monitor outcomes. The results showed consistent enhancement in lower face definition across all patients, with a 98% satisfaction rate and no major adverse events reported. These findings support the use of this anatomically guided protocol as a reproducible and minimally invasive option for lower facial rejuvenation, offering effective aesthetic improvements while maintaining a favorable safety profile.

Facial aging is characterized by soft tissue atrophy, subcutaneous fat redistribution, and dermal laxity, most pronounced in the lower face and submental region. High-intensity focused ultrasound (HIFU) is the benchmark noninvasive lifting modality, whereas microwave energy-based devices (MEBDs) have recently emerged, targeting adipose tissue and dermis. Although MEBD has been validated in body contouring, evidence for facial efficacy and safety remains limited. This study aimed to compare the efficacy and safety of MEBD and HIFU for facial rejuvenation in an East Asian population, emphasizing temporal improvement patterns, tolerability, and adverse events. The authors retrospectively analyzed 171 patients (MEBD: n = 89; HIFU: n = 82) treated at a single institution. MEBD used 7 and 3 mm handpieces for subcutaneous lipolysis and dermal tightening, guided by fat-compartment mapping. HIFU applied 600 shots at 3.0 and 4.5 mm depths targeting the dermis and superficial musculoaponeurotic system. Outcomes included blinded evaluator Global Aesthetic Improvement Scale (GAIS), Cutometer elasticity, Facial Aesthetic Surgery Outcome Questionnaire (FACE-Q) satisfaction, pain, and adverse events, assessed at baseline, 1 month, and 3 months. MEBD showed greater early improvements in GAIS, Cutometer parameters (R2, R5), and FACE-Q scores at 1 month, with lower pain (2.3 vs 4.7, P < .001) and fewer adverse events. By 3 months, HIFU surpassed MEBD in sustained GAIS, FACE-Q, and elasticity gains. Both modalities were safe, with only mild, transient effects. MEBD demonstrated rapid onset, superior tolerability, and lower complication rates, whereas HIFU provided stronger long-term lifting and elasticity improvements. These findings support complementary clinical roles and a compartment-based rationale for facial MEBD.

Central platysmal banding is a common reason that patients seek surgical rejuvenation of the lower face and neck. Numerous surgical methods have been described to address banding, however all have high rates of platysmal band recurrence. Many theories have been proposed to explain the cause of both primary and recurrent platysmal banding, however recently persistent innervation by the cervical branch of the facial nerve has been implicated as the primary cause. This article serves to summarize the available evidence on platysmal banding as well as suggest surgical and non-surgical methods to address primary and recurrent banding.

Poly(D,L-lactic acid) (PDLLA) is increasingly used for skin rejuvenation, utilizing innovative delivery systems like needle-free injectors to enhance patient comfort and efficacy. To evaluate the clinical efficacy and safety of PDLLA delivered through a microjet injector and to assess the durability of its rejuvenating effect over 24 weeks. This study involved 40 patients who underwent five treatment sessions of PDLLA(Juvelook) treatment via a needle-free microjet system. Efficacy was assessed through clinical evaluation (GAIS), patient satisfaction surveys, and 3D imaging analysis at baseline, 8 weeks, and 24 weeks. GAIS scores improved from 1.48 ± 0.32 at baseline to 1.90 ± 0.28 at 8 weeks and 2.16 ± 0.26 at 24 weeks (p < 0.001). Patient satisfaction increased from 3.38 ± 1.12 to 7.95 ± 0.86 (8 weeks) and 8.71 ± 0.69 (24 weeks). 3D imaging showed progressive vector displacement, with a mean displacement of 1.5 ± 0.4 mm at 8 weeks and 2.3 ± 0.5 mm at 24 weeks, indicating sustained lifting and textural improvement. These effects are attributed to the high-velocity microjet delivery mechanism, which enables uniform intradermal dispersion with minimal trauma. PDLLA(Juvelook) delivered via needle-free injection (CUREJET, BAZBIOMEDICCO., LTD.) is a safe and effective modality for facial rejuvenation, offering a promising alternative to conventional methods. Further research is needed to explore long-term outcomes and mechanistic insights. 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 .

Nasolabial folds (NLFs) are prominent facial lines that deepen with age and may adversely affect facial aesthetics and psychosocial confidence. Injectable fillers, including micronized acellular dermal matrix (mADM), offer minimally invasive correction; however, clinical evidence for mADM's safety and efficacy remains limited. We conducted a double-blind, multicenter, randomized controlled trial to compare an mADM filler (Regenfil) with a regulatory agency-approved cross-linked collagen filler (Sunmax Collagen Implant I-Plus). Adults aged ≥18 years with Wrinkle Severity Rating Scale (WSRS) grade 3 or 4 NLFs were randomized to receive mADM or collagen. Six weeks after the initial treatment, a protocol-defined supplemental injection was permitted if additional correction was needed. Outcomes were assessed 6 weeks, 3 months, and 6 months after the last treatment. Efficacy endpoints included blinded-evaluator WSRS, Global Aesthetic Improvement Scale (GAIS) rated by injectors and participants, and participant satisfaction. The prespecified primary endpoint was the percentage of participants achieving a >1-grade WSRS improvement simultaneously on both left and right NLFs. Safety was evaluated by monitoring device-related adverse events and local injection-site reactions. Of 202 randomized participants, 175 completed all required follow-ups for safety and efficacy (mADM, n=86; collagen, n=89). The mADM group required lower mean filling volumes and fewer supplemental injections than the collagen group (P<0.05). At 3 months after the last treatment, the proportion meeting the primary endpoint was 88.4% with mADM versus 85.4% with collagen (P>0.05). At 6 months, efficacy was 70.9% with mADM and 69.7% with collagen (P>0.05). Apart from GAIS and participant satisfaction at 6 weeks, which favored collagen, no statistically significant differences were observed between groups across other efficacy endpoints and timepoints. The most common adverse events were hardening, redness, and skin discoloration at injection sites, occurring at similar frequencies in both groups (P>0.05). Early local reactions such as swelling and pain were more frequent with mADM (P<0.05), but were predominantly mild to moderate and resolved within one week. No treatment-related serious adverse events were reported. In this multicenter, randomized, double-blind trial, mADM demonstrated safety and effectiveness for correcting moderate-to-severe NLFs, with outcomes comparable to a cross-linked collagen filler through 6 months. Compared with collagen, mADM achieved similar correction with less product volume and fewer supplemental injections, while showing a transient increase in early local reactions that were self-limited. These findings support mADM as a minimally invasive, injectable tissue-regenerative bioscaffold and a viable alternative for facial rejuvenation. Comparable Efficacy: mADM filler demonstrated similar effectiveness to collagen fillers in reducing moderate-to-severe nasolabial folds. Enhanced tissue remodeling: Histological analysis showed that mADM promotes collagen deposition, fibroblast proliferation, and vascularization. Minimally Invasive & Safe: While early adverse reactions (swelling, pain) were slightly higher with mADM, they were mild, self-limiting, and resolved within a week. Lower Injection Volume Needed: mADM required significantly less filler volume and fewer supplemental injections compared to collagen fillers. 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 .

Summary:Lip lift is a versatile procedure to shorten the upper lip and improve the morphology and proportion of the lip. It is commonly performed as part of facial rejuvenation in Western patients, whereas in Asian countries, younger people tend to desire a lip lift because a shorter upper lip is considered more attractive. The lip lift carries a risk of an unfavorable aesthetic outcome when underlying skeletal deformities, such as maxillary protrusion and vertical excess, are not addressed, resulting in an undesirable degree of dental exposure. This article described our experience of integrating orthognathic surgery into subnasal lip lift surgery to harmonize the facial profile, highlighting the methods to achieve an ideal dental show with lip lift. Orthognathic surgery was first performed to correct the skeletal deformity. Subnasal lip lift with bull’s horn-type skin excision and orbicularis oris muscle resection was then performed as a staged procedure. The degree of Cupid’s bow elevation was determined by the amount of skin excised, and incisor show was determined by the amount of muscle resected. Seventeen patients underwent this combination approach, and the upper lip was successfully shortened with appropriate proportions and dental show. Overall, the aesthetic results were pleasing, with high patient satisfaction. Integrating orthognathic surgery into a lip lift aids in the enhancement of perioral aesthetics. Preexisting skeletal deformities need to be diagnosed before the lip lift and should be corrected when indicated.

Regenerative medicine has rapidly evolved into a central pillar of aesthetic and reconstructive surgery, integrating cellular therapies, autologous biologics, biomaterials and advanced biofabrication platforms. This review synthesizes evidence from twenty peer-reviewed studies to examine how these modalities contribute to tissue restoration, improve structural and functional outcomes and reshape surgical practice. Cell-based approaches—particularly mesenchymal and adipose-derived stem cells—emerged as the most frequently investigated strategies, reflecting their capacity to modulate inflammation, enhance angiogenesis and promote extracellular matrix remodeling. Autologous biologics such as platelet-rich plasma and regenerative fat grafting also demonstrated widespread application due to their accessibility and compatibility with established clinical workflows. Concurrently, biomaterial-based techniques and 3D bioprinting technologies are expanding reconstructive possibilities, enabling more personalized and anatomically precise interventions. Across indications ranging from facial rejuvenation and breast reconstruction to cartilage engineering and wound repair, regenerative modalities consistently demonstrated potential to improve tissue quality and aesthetic outcomes. Although heterogeneity in protocols and limited long-term data remain challenges, the convergence of biological science, materials engineering and surgical innovation positions regenerative medicine as a transformative paradigm for future clinical practice.

Objectives: The objective of the study is to evaluate the clinical effectiveness and patient satisfaction associated with Aptos poly-L-lactic acid and ε-caprolactone (P[LA/CL]) hyaluronic acid (HA)-enriched lifting threads (Visage Excellence Method HA), used alone or in combination with additional thread methods, across varying degrees of facial laxity as classified by the facial laxity rating scale (FLRS). Materials and Methods: A prospective interventional study was conducted involving 60 patients stratified by FLRS into three treatment groups: Group 1 (FLRS 2–4) received Visage Excellence Method HA in the midface; Group 2 (FLRS 5–6) received additional jawline lifting using light lift thread method; and Group 3 (FLRS 7–9) received midface, jawline, and neck lifting using both light lift thread and light lift needle methods. Assessments were conducted at baseline and at 1, 3, and 6 months post-implantation using the FLRS (clinician-assessed), FACE-Q (satisfaction with skin and outcome modules), and the Global Aesthetic Improvement Scale (GAIS). Non-parametric statistical analyses were applied. Results: All groups demonstrated statistically significant reductions in FLRS scores at all follow-up points ( P &lt; 0.001). A consistent 0.7–1.0 point mean decrease from baseline was sustained over 6 months, with the greatest changes observed within the first 3 months. FACE-Q satisfaction with outcome and satisfaction with skin scores increased significantly ( P &lt; 0.001), with Group 2 reporting the highest levels of satisfaction at 6 months. GAIS scores indicated “very improved” results in 97% of patients at 1 month, slightly declining by 6 months, but still reflecting positive esthetic outcomes. No serious adverse events occurred. Minor side effects, such as swelling, tightness, and bruising, were transient and resolved spontaneously within one week. Conclusion: P(LA/CL) HA threads, either alone or in combination with additional thread techniques, demonstrated statistically significant clinical improvements in facial laxity and high levels of patient-reported satisfaction across all severity grades. Tailoring thread-lifting strategies based on FLRS grading yields effective and safe outcomes, with the most favorable balance of clinical and subjective results observed in moderate laxity cases. These findings support the use of P(LA/CL)-HA threads as a minimally invasive, patient-centered approach to facial rejuvenation.

Deep-plane facelift (DPF) and its extended modification (EDPF) have been developed to address age-related changes in the lower face, particularly marionette lines, jowls, and neck laxity. Although both techniques provide durable rejuvenation, direct comparative data remain limited. The authors of this study aim to compare the clinical effectiveness of DPF and EDPF in correcting lower facial aging, with emphasis on marionette lines, cervical laxity, and jowling. A prospective cohort study was conducted on 70 patients (mean age: DPF 51.7, EDPF 55.1 years; 95.7% female) between April 2023 and March 2025. Patients were randomized to undergo DPF or EDPF by a single surgeon. Standardized preoperative and 9-month postoperative photographs were independently assessed by 2 blinded ENT surgeons using validated photonumeric scales. Statistical analyses included Wilcoxon signed-rank and Mann-Whitney U tests. Both facelift methods achieved significant postoperative improvements (P < .001). However, EDPF consistently demonstrated superior outcomes in reducing marionette lines (P < .001), improving cervical laxity (P < .01), and correcting jowls (P < .05). No permanent facial nerve injuries or major complications were observed. Although both DPF and EDPF are effective in lower facial rejuvenation, the extended technique provides greater and more consistent improvements, particularly in marionette line correction and jawline-neck contouring. These findings support EDPF as a safe, anatomically sound advancement in facial rejuvenation, warranting further longitudinal and multicenter evaluation.