Facial Skin Laxity Research Articles

The Role of GLP-1 Agonists in Esthetic Medicine: Exploring the Impact of Semaglutide on Body Contouring and Skin Health.

Glucagon-like peptide-1 (GLP-1) receptor agonists, such as semaglutide, have revolutionized the treatment of diabetes and obesity by promoting significant weight loss through incretin effects. However, rapid weight reduction induced by these medications often leads to esthetic challenges, including facial volume loss, skin laxity, and body contour irregularities. This commentary reviews the esthetic consequences of GLP-1-induced weight loss and explores solutions for managing these concerns in clinical practice. This review synthesizes available literature and clinical observations to identify key esthetic concerns associated with GLP-1-induced weight loss. It examines various treatment modalities, including dermal fillers, biostimulatory agents, energy-based devices, and surgical procedures. The discussion highlights gaps in empirical data, optimal timing for interventions, and the need for personalized, multimodal treatment strategies. Imaging tools and psychological support are also considered as complementary approaches. As GLP-1 agonists become a cornerstone in obesity management, their esthetic implications necessitate a proactive response from esthetic practitioners. Effective management of facial volume loss, skin laxity, and body contour challenges requires a combination of injectable treatments, energy-based devices, and, in some cases, surgical interventions. Future research should focus on understanding the molecular mechanisms of skin and fat changes and developing standardized guidelines for treating this unique patient population. Additionally, a holistic approach that addresses both physical and psychological outcomes is critical to ensuring patient satisfaction and long-term well-being.

Bipolar Radiofrequency Combined with Non-Crosslinked Hyaluronic Acid Mesotherapy: A Protocol for Skin Enhancement

Changes associated with aging, such as alterations in epidermal hydration, pigmentation, thickness, and cell renewal, impact skin appearance and may result in laxity, dryness, and uneven skin tone. This case series aimed to evaluate the combined effects of bipolar radiofrequency and non-crosslinked hyaluronic acid mesotherapy on skin appearance, with the goal of achieving synergistic benefits. This retrospective data analysis included subjects aged 33-67 years with facial skin dryness and laxity. Subjects received treatment with a bipolar radiofrequency device on the face, followed immediately by mesotherapy with 2.5 ml of non-crosslinked hyaluronic acid. Photographic documentation and skin analysis were conducted before treatment and 30 days post-treatment. Fourteen subjects with a mean age of 45 years (range 33-67) and presenting with dry, lax facial skin were included. All measured indicators showed significant improvement following the combined radiofrequency and mesotherapy protocol. The combined protocol also correlated with greater improvement in both patient and physician satisfaction, observed immediately after the procedure and at 30 days post-procedure. The treatment was well tolerated, and no adverse events were reported. The combination of bipolar radiofrequency and non-crosslinked hyaluronic acid mesotherapy resulted in significant improvements in skin appearance, firmness, tone, and overall subject satisfaction compared to the baseline condition. The treatments were well received, leading to noticeable enhancements in facial aesthetics. No adverse events were reported, confirming the safety of the protocol.

Patient satisfaction following treatment with micro-focused ultrasound with visualization: A retrospective cross-sectional study.

There has been increased public interest in noninvasive skin tightening procedures that produce the best possible cosmetic outcomes. Micro-focused ultrasound with visualization (MFU-V) is a secure, efficient method of treating skin laxity approved by the FDA. Few studies have assessed patient satisfaction following MFU-V. A retrospective cross-sectional study was conducted between January 2022 and 2023. After obtaining the author's permission, a previously examined and published questionnaire was used to contact all participants (n=98) who had received MFU-V therapy in a private clinic in Riyadh, Saudi Arabia, between 2016 and 2020 via phone interview. All 98 patients undergoing MFU-V were female. About two-thirds indicated they were satisfied or very satisfied with the results. Those receiving treatment around the eye and submentum reported lower satisfaction levels than those receiving therapy in other regions. The number of treatment locations and satisfaction were positively correlated. Patients treated by consultants rather than laser experts reported much higher satisfaction levels. Satisfaction and the amount of time for improvement to occur following treatment were correlated statistically. Pain and tingling were the most frequent adverse effects the respondents reported, followed by skin redness and swelling; however, adverse effects were not connected with satisfaction. Cost (78.6%) was cited as the main deterrent to seeking treatment again. MFU-V, an FDA-approved procedure, has proven effective and safe for treating facial and neck skin laxity. When patients are carefully selected and physicians properly trained, higher satisfaction is achieved.

Efficacy and safety of a novel monopolar radiofrequency device with a continuous water-cooling system in patients with age-related facial volume loss

Background Esthetic radiofrequency (RF) technology has much attracted public attention with the increasing demand for skin rejuvenation. A continuous water cooling-based monopolar RF (MRF) device was designed for the first time to protect the epidermis and maximize clinical outcomes. Objective Assess the efficacy and safety of the proposed MRF device in patients with mild-to-moderate sunken cheeks and jawline laxity. Methods Twenty-one patients underwent a single session of MRF treatment. Quantitative analysis was performed using a 3D imaging technique. Postprocedural clinical improvements were assessed with the Merz Scale. Regarding safety, adverse events (AEs), thermal sensation (TS) and pain intensity were explored. Patient satisfaction was surveyed with the Self-Assessment Questionnaire (SAQ). Results The follow-up investigation demonstrated that facial volume increased across the cheek and jawline, with lifting effects throughout the treatment area. The Merz Scale assessment revealed that sunken cheeks, sagging jawlines and wrinkles were markedly improved. In addition, there were transient AEs, mild TS and moderate pain. In SAQ, 81% patients were satisfied with the procedure. Conclusions This study provided quantitative evidence for postprocedural volumetric increases along with enhanced lifting effects, strongly implying that the proposed MRF device can be an attractive option for improving facial skin volume loss and laxity.

Blending Hyaluronic Acid and Calcium Hydroxylapatite for Injectable Facial Dermal Fillers: A Clinical and Ultrasonography Assessment

Both hyaluronic acid (HA) and calcium hydroxylapatite (CaHA) fillers have well-established indications in cosmetic medicine. Nevertheless, limited data are available on the effectiveness of combining CaHA and HA. The purpose of this report was to demonstrate the safety, tolerability, and clinical and ultrasonographic improvement of facial skin laxity using a blending technique that admixes HA and CaHA. Fifteen regular patients, including three men, between 25 and 71 years of age were reported. The participants were subjects who came regularly to the dermatologic office seeking a lifting effect without surgery. They were submitted to injection of an admixture of HA and CaHA and followed for 180 days. The clinical assessment consisted of photographic evaluation by two blind investigators, and a consensual subjective evaluation was performed by the physicians (PGAIS) using the five-point Global Aesthetic Improvement Scale. Dermal thickness was analyzed in jaw areas using high-frequency ultrasound. Subjects completed a satisfaction questionnaire with responses scored according to the five-point Global Aesthetic Improvement Scale (GAIS) to evaluate patient satisfaction. After 180 days of follow-up, clinical assessments by blinded physicians found that all patients improved. All the participants were highly satisfied with the results and reported exceptional improvement. Dermal thickness increased by 9.4% (8.2–10.8%), 14.0% (12.2–15.9%), and 18.8% (16.2–21.9%) at D90, D120, and D180, respectively, by ultrasonography. In conclusion, an injection technique using an admixture of CaHA and HA fillers was well tolerated, offering high satisfaction and long-lasting progressive benefits. The authors believe that this procedure optimizes the treatment time and results because HA promotes early volume restoration and CaHA stimulates long-term dermal remodeling through the synthesis of collagen and elastin.

Extending the Range of Measurement for Minimally Invasive Treatments by Adding New Concepts to FACE-Q Aesthetics Scales.

The Satisfaction with Face Overall and Psychological Function scales are the most frequently used FACE-Q Aesthetics module scales. This study aimed to extend their range of measurement by adding and testing new concepts. We aimed to create FACE-Q Aesthetics item libraries. In-depth concept elicitation interviews were conducted. Concepts were formed into items and refined through multiple rounds of patient and expert input. The items were tested with people living in the United States, Canada, and the United Kingdom who had minimally invasive facial aesthetic treatments. Participants were recruited through an online platform (ie, Prolific). Psychometric properties were examined using Rasch measurement theory analysis, test-retest reliability, and construct validity. We conducted 26 interviews. New concepts were developed into items and refined with input from 12 experts, 11 clinic patients, and 184 Prolific participants. A sample of 1369 Prolific participants completed 52 appearance and 22 psychological items. After removing 10 and 2 items respectively, the psychometric tests provided evidence of reliability with the person separation index, Cronbach alpha, and test-retest reliability values without extremes of 0.88 or more. For validity, lower scores were associated with looking older than one's age, being more bothered by facial skin laxity, treatment wearing off, and having deeper lines on Merz Assessment scales. Short-form scales formed from the 42 appearance items provide examples of item library application. This study provides an innovative means to customize scales to measure appearance and psychological function that maximizes content validity and minimizes respondent burden in the context of minimally invasive treatments.

Treatment with synchronized radiofrequency and facial muscle stimulation: Histologic analysis of human skin for changes in collagen and elastin fibers.

Skin's exposure to intrinsic and extrinsic factors causes age-related changes, leading to a lower amount of dermal collagen and elastin. This study investigated the effects of a novel facial muscle stimulation technology combined with radiofrequency (RF) heating on dermal collagen and elastin content for the treatment of facial wrinkles and skin laxity. The active group subjects (N = 6) received four 20-min facial treatments with simultaneous RF and facial muscle stimulation, once weekly. The control subject (N = 1) was untreated. Skin biopsies obtained at baseline, 1-month and 3-month follow-up were evaluated histologically to determine collagen and elastin fibers content. A group of independent aestheticians evaluated facial skin appearance and wrinkle severity. Patient safety was followed. In the active group, collagen-occupied area reached 11.91 ± 1.80 × 106 μm2 (+25.32%, p < 0.05) and 12.35 ± 1.44 × 105 μm2 (+30.00%, p < 0.05) at 1-month and 3-month follow-up visits. Elastin-occupied area at 1-month and 3-month follow-up was 1.64 ± 0.14 × 105 μm2 (+67.23%, p < 0.05), and 1.99 ± 0.21 × 105 μm2 (+102.80%, p < 0.05). In the control group, there was no significant difference (p > 0.05) in collagen and elastin fibers. Active group wrinkle scores decreased from 5 (moderate, class II) to 3 (mild, class I). All subjects, except the control, improved in appearance posttreatment. No adverse events or side effects occurred. Decreased dermal collagen and elastin levels contributes to a gradual decline in skin elasticity, leading to facial wrinkles and unfirm skin. Study results showed noticeable improvement in facial appearance and increased dermal collagen and elastin content subsequent to simultaneous, noninvasive RF, and facial muscle stimulation treatments.

Dynamic Reconstruction Using Bilateral Lengthening Temporalis Myoplasty for Facial Palsies in Patients with Hereditary Skin Laxity.

Hereditary skin laxity is a rare condition, some cases of which are also referred to as cutis laxa, and those involving facial skin are considered a target for treatment by plastic surgery as patients present with an aged face, which can reduce their quality of life. In some of these patients, the facial nerve and muscles may be affected, and cause weakness of mimetic muscles. We performed one-stage bilateral lengthening temporalis myoplasty reanimation, followed by lower facial contouring with partial lower lip excision and hammock-shaped fascia grafting in two patients with hereditary facial skin laxity coexisting with facial palsy. The patient was a 63-year-old woman with hereditary gelsolin amyloidosis and a 64-year-old man who was diagnosed with oculopharyngeal muscular dystrophy. Postoperatively, a symmetrical facial contour was achieved in repose, and smiling with and without biting was possible. To our knowledge, there are no reports of dynamic smile reconstruction for facial weakness in patients with hereditary facial skin laxity. Although these patients may experience progressive loss of function of the trigeminal nerve and its innervating muscles, the static suspension effect of lengthening temporalis myoplasty can be expected to continue even if the temporal muscles lose their function in the future. We believe that, with careful patient selection, dynamic reconstruction is an option for progressive facial paralysis. In this article, we present the chronological history of two patients who underwent multiple plastic surgery procedures and discuss the importance of the role of plastic surgery in improving the quality of life under these conditions.

Microneedling Radiofrequency Enhances Poly-L-Lactic Acid Penetration That Effectively Improves Facial Skin Laxity without Lipolysis.

Microneedle fractional radiofrequency (MFR) is commonly used for skin laxity treatment, and poly-L-lactic acid (PLLA) can stimulate collagen synthesis in the body. However, the synergy of their combination for skin rejuvenation has not been proven. The authors aimed to evaluate the combined efficacy of PLLA and MRF and the potential mechanism underlying skin laxity. This prospective, randomized study included C57BL/6 mice treated with MFR, MFR plus PLLA, and carbon dioxide laser plus PLLA and 32 patients who underwent split-face treatments with MFR or MFR plus PLLA twice every 2 months. The Global Aesthetic Improvement Scale, Facial Laxity Rating scale of the whole face, the Echelle d'Evaluation Clinique des Cicatrices d'Acne grading scale of acne scars, and VISIA parameters on both treated sides were evaluated. Dermatologic changes were measured by ultrasonography in the submental space, and adverse events were documented. PLLA was delivered by channels produced by MFR but not carbon dioxide laser in the mouse model. Thirty patients were treated with split-face MFR plus PLLA or MFR, revealing an improvement in VISIA wrinkle percentile (0.020) compared with the age-matched controls (0.000). The thickness of the dermis increased, whereas the fat layer did not change significantly. No adverse effects were observed. PLLA can be delivered through microchannels produced by MFR. PLLA enhances the efficacy of MFR for skin laxity without lipolysis.

Treatment Protocol on Using Microfocused Ultrasound with Visualization for Skin Quality Improvement: The Korean Experience.

Facial skin quality profoundly influences an individual's perceived appearance and is an important aspect of facial rejuvenation. Facial pore enlargement is one of the most common concerns among Asian individuals that adversely impacts perceived skin surface evenness and affects overall skin quality. One of the major causes of enlarged pores is facial skin laxity. Microfocused ultrasound with visualization (MFU-V; Ultherapy; Merz North America, Inc., Raleigh, N.C.) is indicated for lifting and tightening of the face and neck, and improving the appearance of wrinkles on the décolletage. In addition, it is useful for addressing several aspects of facial rejuvenation, including facial pores, skin laxity, skin unevenness, etc., but there is limited literature on these applications. Thus, we present our proposed MFU-V treatment protocol for achieving a harmonious outcome for attractive skin, along with practical strategies for its application, illustrated in patients presenting with enlarged pores as their main concern. Drawing on our collective experience in using MFU-V for facial rejuvenation and the recently published skin quality framework that advocates addressing interrelated attributes of skin quality for optimal outcomes, we developed a treatment protocol for improving skin quality using MFU-V. This MFU-V treatment protocol reliably improves overall skin quality in patients presenting with enlarged pores, through MFU-V's effects on skin lifting and tightening, and consequent improvement in facial pores and skin texture. This treatment protocol can be readily used as part of a multimodal layering approach to yield successful outcomes in patients with various facial skin concerns.

Clinical and histological evaluation of microneedle fractional radiofrequency treatment on facial fine lines and skin laxity in Koreans.

Facial wrinkles and sagging are the most visible signs of aging and can cause profound distress. Microneedle fractional radiofrequency (MFR) is a minimally invasive procedure, which utilizes both microneedling and radiofrequency energy to rejuvenate the skin. To describe the safety and efficacy of a temperature-controlled MFR device on facial fine lines and laxity. A retrospective chart & histology review was performed on individuals who received bipolar MFR for facial rejuvenation. A total of 15 Koreans with a median age of 46 years were included. All participants underwent a single treatment session. The results were assessed objectively using serial photography and subjectively based on the participants' satisfaction scores. Histologic changes before, immediately after MFR and at 4months follow-up was examined. Complications were also recorded. Partially denatured collagen fibers and dermal shrinkage was observed immediately after MFR whereas an increase in elastin and collagen was noted at 4months follow-up. 86.7% of recipients considered the results satisfactory. Consensus ratings by two independent dermatologists on the objective outcomes at 4-month follow-up were very much improved (53.3%), much improved (26.7%) and improved (20%). Treatment was well tolerated and did not cause any significant long-lasting discomfort. Temperature-controlled bipolar MFR is a minimally invasive treatment option to consider for facial fine lines and laxity via neo-collagenesis and neo-elastogenesis. The procedure was safe and clinically effective.

HA PEGylated Filler in Association with an Infrared Energy Device for the Treatment of Facial Skin Aging: 150 Day Follow-Up Data Report.

The face is the area most exposed to the normal course of skin aging, both intrinsically and extrinsically. The aim of the study was to evaluate the cellular and clinical response of a therapeutic protocol aimed at countering facial skin aging. Twenty female patients with facial skin laxity and photodamage underwent combined therapy including mesotherapy using non-cross-linked hyaluronic acid with calcium hydroxyapatite and an infrared energy-based device treatment with subsequent implementation of PEG-cross-linked hyaluronic acid soft tissue fillers. To evaluate the benefits, patients underwent histological, immunological, and biomechanical evaluations before the treatment and at 21 and 150 days after the treatment. The histological results at 21 days and 150 days after the procedure showed an increase in the number of fibroblasts and angiogenesis. As for the immunological aspect, it was shown that the treatment has an immunomodulating action, avoiding the activation of CD4 and CD8 cells. Biomechanical data showed that, at 150 days after treatment, the average changes in skin elasticity increased by 72% and the skin hydration increased by 49%. A combination of an infrared energy-based device treatment with both non-cross-linked hyaluronic acid and novel PEG-cross-linked hyaluronic acid leads to numerous positive cutaneous changes after histological, immunological, and biomechanical evaluations.

Efficacy and Safety of Monopolar Radiofrequency for Treatment of Lower Facial Laxity in Asians.

IntroductionMonopolar radiofrequency (MRF) is a valuable modality for tightening and contouring mild-to-moderate facial skin laxity. Few studies have evaluated new-generation MRF devices for lower facial laxity in Asians. This study aims to evaluate the efficacy and safety of MRF for treating lower facial laxity in Asians.MethodsThis prospective cohort study enrolled 30 volunteers with Fitzpatrick Skin Types III–V and mild-to-moderate skin laxity. Subjects received a single MRF treatment. Self-assessments and adverse events were recorded. Two blinded dermatologists graded improvements (6-point scale) after treatment and 1, 3, and 6 months later.ResultsAll subjects completed the study. Treatment energy levels ranged from 2 to 4. The average number of shots was 412 ± 49, delivered in 3–4 passes with 15–30% overlap. All patients reported improvement in lower facial laxity immediately after treatment. Most patients had mild-to-moderate improvement over the 6-month follow-up. Continuous improvement was observed at the 1-, 3-, and 6-month follow-ups (P < 0.01). Significant improvement was seen at the 6-month follow-up compared with the 1-month follow-up (P < 0.01). Subjects tolerated the procedure well: the average pain score was 3.13 out of 10, and no serious adverse events were observed.ConclusionsThe new-generation MRF device we tested was effective and safe for mild-to-moderate lower facial laxity in Asian skin. The latest MRF technology offers improved safety to prevent complications. Appropriate patient selection, setting, and protocols are mandatory to achieve optimal clinical outcomes.The Trial Registration NumberTCTR20210326002.

Improvement of Facial Skin Laxity by a Combined Technique With Hyaluronic Acid and Calcium Hydroxylapatite Fillers: A Clinical and Ultrasonography Analysis.

Facial aging involves skeletal changes, loss of volume in the fat compartment, and skin component changes. The current objective of cosmetic facial filling is to reestablish the overall aspect that was lost during the aging process. Hyaluronic acid (HA) and calcium hydroxyapatite (CaHA) fillers are indicated for facial rejuvenation, and these agents promote dissimilar effects regarding volume restoration and dermal biostimulation. This study aimed to assess clinical and ultrasonographic improvements in facial skin laxity using a technique that combines the injection of HA and CaHA. A 120-day follow-up, quasi-experimental study was conducted based on the enrollment of fifteen women (36&ndash;47 years old) with mild face flaccidity scores who underwent subcutaneous injection of up to 3 mL of HA (zygomatic-malar region, pyriform aperture, temporal region, and jaw) followed by 3 mL of 1:1 diluted CaHA using a fan technique (temporal, zygomatic-malar, and jaw regions). Adverse effects were registered, and the monthly assessed outcomes included clinical improvement, satisfaction, and high-frequency ultrasonography (dermal thickness) parameters. At 120 days of follow-up, clinical assessment by blinded physicians yielded six (40%) very improved patients and nine (60%) exceptionally improved patients. All the participants were highly satisfied with the results and reported exceptional improvement. Dermal thickness increased 11.1% (8.8&ndash;13.4%), and augmented dermal homogeneity was evidenced by ultrasonography. Local adverse effects were mild and transient. In conclusion, the combined technique with HA and CaHA fillers was well-tolerated and yielded high satisfaction and safe improve in facial skin laxity and dermal thickness in women with mild midface aging. J Drugs Dermatol. 2022;21(1): 102-106. doi:10.36849/JDD.633.

Improvement of Facial Skin Laxity by a Combined Technique With Hyaluronic Acid and Calcium Hydroxylapatite Fillers: A Clinical and Ultrasonography Analysis

Background: Facial aging involves skeletal changes, loss of volume in the fat compartment, and skin component changes. The current objective of cosmetic facial filling is to reestablish the overall aspect that was lost during the aging process. Hyaluronic acid (HA) and calcium hydroxyapatite (CaHA) fillers are indicated for facial rejuvenation, and these agents promote dissimilar effects regarding volume restoration and dermal biostimulation. Objective: This study aimed to assess clinical and ultrasonographic improvements in facial skin laxity using a technique that combines the injection of HA and CaHA. Methods: A 120-day follow-up, quasi-experimental study was conducted based on the enrollment of fifteen women (36–47 years old) with mild face flaccidity scores who underwent subcutaneous injection of up to 3 mL of HA (zygomatic-malar region, pyriform aperture, temporal region, and jaw) followed by 3 mL of 1:1 diluted CaHA using a fan technique (temporal, zygomatic-malar, and jaw regions). Objective: Adverse effects were registered, and the monthly assessed outcomes included clinical improvement, satisfaction, and high-frequency ultrasonography (dermal thickness) parameters. Results: At 120 days of follow-up, clinical assessment by blinded physicians yielded six (40%) very improved patients and nine (60%) exceptionally improved patients. All the participants were highly satisfied with the results and reported exceptional improvement. Dermal thickness increased 11.1% (8.8–13.4%), and augmented dermal homogeneity was evidenced by ultrasonography. Local adverse effects were mild and transient. Conclusion: In conclusion, the combined technique with HA and CaHA fillers was well-tolerated and yielded high satisfaction and safe improve in facial skin laxity and dermal thickness in women with mild midface aging. J Drugs Dermatol. 2022;21(1): 102-106. doi:10.36849/JDD.633Hyaluronic Acid and Calcium Hydroxylapatite Fillers

Commentary on Prospective Clinical Trial of the Latest Generation of Noninvasive Monopolar Radiofrequency for the Treatment of Facial and Upper Neck Skin Laxity

Commentary on Prospective Clinical Trial of the Latest Generation of Noninvasive Monopolar Radiofrequency for the Treatment of Facial and Upper Neck Skin Laxity

Prospective Clinical Trial of the Latest Generation of Noninvasive Monopolar Radiofrequency for the Treatment of Facial and Upper Neck Skin Laxity.

Aging of the face and upper neck is a complex process characterized by loss of collagen and elastic fibers, resulting in clinical skin laxity. Noninvasive interventions such as monopolar capacitively coupled radiofrequency (MRF) have gained popularity, offering a safer and more convenient alternative to traditional surgical face lift. The latest MRF device features larger tips, vibration, cooling, and impedance matching. We performed the first open-label clinical trial, measuring the efficacy, safety, and patient satisfaction of this device for noninvasive lifting and tightening of the face and upper neck. Forty subjects 30 to 60 years of age with mild/moderate skin laxity of the face and upper neck were enrolled. After pretreatment with ketorolac 60 mg intramuscular injection, subjects underwent treatment with MRF. Follow-up evaluations were performed on Days 30, 60, and 180. Our study demonstrated that the newest generation MRF produced statistically significant improvement in skin laxity 6 months post-treatment, especially in the jowls and melolabial folds. According to the Investigator Global Aesthetic Improvement Score, 73% of subjects had improvement at 6 months post-treatment. Subject satisfaction and improvement questionnaires supported these findings. Our data coupled with the excellent adverse effect profile validates MRF as an attractive treatment modality for facial and upper neck skin laxity.

Intradermal Microdroplet Injection of Diluted Incobotulinumtoxin-A for Sebum Control, Face Lifting, and Pore Size Improvement.

Intradermal injections of botulinum toxin have been reported to improve sebum secretion, facial skin laxity, and facial pores. However, the effects of Incobotulinumtoxin-A for these indications have not been reported. To evaluate the efficacy of Incobotulinumtoxin-A for the improvement of sebum secretion, face laxity, and facial pores. This single-center retrospective study included patients treated with Incobotulinumtoxin-A to improve facial skin laxity, sebum secretion, and facial pores. The microdroplet injection protocol included injection points on the lateral face, anterior medial cheek, mandibular line, depressor anguli oris points, mid-glabella area, and chin. Outcomes were measured using a Sebumeter and three-dimensional scanner and were evaluated by facial laxity ratings and the Global Aesthetic Improvement Scale. Twenty patients were included in the analysis. Sebum secretion, mandibular length, facial pores, and facial laxity ratings were improved at 1 week and results were sustained through 12 weeks. All outcomes showed maximum improvement after 4 weeks. Evaluation using the Global Aesthetic Improvement Scale showed that all subjects reported at least a score of 2 (improved) after 4 weeks. This study showed that intradermal injection with Incobotulinumtoxin-A could be effective for face lifting, reduced sebum production, and improved facial pores. J Drugs Dermatol. 2021;20(1):49-54. doi:10.36849/JDD.5616.

Aesthetic evolution drives birth of minimally invasive surgery subgroup.

Facial and neck skin tightening, and rejuvenation began decades ago with maximally invasive incisional face-lift surgery. Aesthetic trends, patient demands, and innovative technology brought about minimally invasive and noninvasive interventions-such as radiofrequency, ultrasound, laser and intense pulsed light as well as dermal fillers and other injectables-to address facial and neck skin laxity. These procedures reduce facial and neck skin laxity with less risk and less downtime than maximally invasive face-lift or face-lift plus liposuction; however, these interventions are often deemed to offer reduced results. To evaluate the safety and efficacy-as well as patient satisfaction-of Rotational Fractional Resection (RFR) in subjects with mild-to-moderate submental fat and mild-to-moderate submental skin laxity. Rotational fractional resection with the Nuvellus (Recros, Inc) platform, which uses 1.5 mm in diameter rotating scalpels-termed scalpets-to resect lax skin followed by a rotating cannulas to perform focal lipectomy through resected access ports. Thirtyone patients were evaluated 30 days after RFR, in an ongoing prospective, multi-center, nonrandomized study. The majority of subjects had a ≥1-grade improvement in investigator-evaluated skin laxity and lipodystrophy; 84% of subjects were satisfied with their neck and jawline appearance and 97% of subjects they would likely recommend the procedure. Minimal procedural and post-procedural pain, minimal scarring in 94% of subjects, and no severe skin-related adverse effects. Rotational fractional resection is essentially a new concept that has a risk and side effect profile that is comparable or better than-surgical skin tightening, with measurable permanent results approaching that of surgical skin tightening. This investigational procedure advances the evolution of facial and neck aesthetic procedures with results approaching those of surgery in a single treatment. Early RFR results are promising but, yet to be conclusive. However current outcome reports identify a procedure that meet patient demands for a minimally invasive office- based procedure to look better with limited downtime.

Clinical Evaluations of a Novel Thread Lifting Regimen Using Barbed Polyglyconate Suture for Facial Rejuvenation: Analysis Using a 3-Dimensional Imaging System.

Thread lifting with absorbable sutures has recently gained prominence for rejuvenating ptotic and sagging soft tissues in aging face. A barbed, delayed absorbable polyglyconate monofilament shows significantly high tensile loads with superior flexibility and elasticity. To evaluate the safety and efficacy of novel thread lifting regimen with barbed polyglyconate suture for counteracting the descent and laxity of the aging face. A retrospective chart review was conducted for 25 Korean patients with mild to moderate facial skin laxity receiving thread lifting procedures using barbed polyglyconate suture. Dermatologists' objective assessments using a 5-point Global Aesthetic Improvement Scale (GAIS), 3D imaging system, and subjective satisfaction were recorded at baseline and 4 months after treatments. In most patients (84%), GAIS scores were more than score 3 ("improved"), with 40% of score 4 ("much improved") and 24% of score 5 ("excellent") at the follow-up point. Subjective assessments paralleled these patterns. Three-dimensional analysis quantitatively showed volume migration of low face upward, clinically interpreted as facial lifting. No serious adverse effect was observed. This novel thread lifting procedure using barbed polyglyconate suture is a safe and effective method for tightening and lifting for aging face with mild to moderate face sagging.