Global Aesthetic Improvement Scale Scores Research Articles

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

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

Cold atmospheric plasma therapy for Malassezia folliculitis: Laboratory investigations and a randomized clinical trial.

Current treatment options for Malassezia folliculitis (MF) are limited. Recent research has demonstrated the inhibitory effect of cold atmospheric plasma (CAP) on the growth of Malassezia pachydermatis in vitro, suggesting CAP as a potential therapeutic approach for managing MF. The objective of our study is to assess the in vitro antifungal susceptibility of Malassezia yeasts to CAP. Additionally, we aim to evaluate the efficacy and tolerability of CAP in treating patients with MF. We initially studied the antifungal effect of CAP on planktonic and biofilm forms of Malassezia yeasts, using well-established techniques such as zone of inhibition, transmission electron microscopy, colony count assay and 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide salt assay. Subsequently, a randomized (1:1 ratio), active comparator-controlled, observer-blind study was conducted comparing daily CAP therapy versus itraconazole 200mg/day for 2weeks in 50 patients with MF. Efficacy outcomes were measured by success rate, negative microscopy rate and changes in Dermatology Life Quality Index (DLQI) and Global Aesthetic Improvement Scale (GAIS) scores. Safety was assessed by monitoring adverse events (AEs) and local tolerability. In laboratory investigations, CAP time-dependently inhibited the growth of Malassezia yeasts in both planktonic and biofilm forms. Forty-nine patients completed the clinical study. At week 2, success was achieved by 40.0% of subjects in the CAP group versus 58.3% in the itraconazole group (p=0.199). The negative direct microscopy rates of follicular samples were 56.0% in the CAP group versus 66.7% in the itraconazole group (p=0.444). No significant differences were found in the proportion of subjects achieving DLQI scores of 0/1 (p=0.456) or in the GAIS responder rates (p=0.588) between the two groups. Three patients in the CAP group and one patient in the itraconazole group reported mild AEs. CAP demonstrated significant antifungal activity against Malassezia yeasts in vitro and exhibited comparable efficacy to itraconazole in treating MF patients. Without the associated adverse effects of oral antifungal drugs, CAP can be considered a promising and safe treatment modality for MF.

Fractional picosecond laser treatment of non-acne atrophic scars and scar erythema in Chinese patients.

Fractional picosecond lasers (FPL) are reported to be effective and safe for atrophic acne scars and post-acne erythema. However, there is no evidence regarding the effectiveness and safety of FPL treatment for non-acne atrophic scars and scar erythema among Chinese patients. In this retrospective study, 12 Chinese patients with non-acne atrophic scars, including nine with scar erythema, were treated with one to three sessions of 1064nm FPL treatment. Clinical improvement was objectively assessed through blinded evaluations by external physicians. A modified Manchester Scar Scale (mMSS) and the Clinician Erythema Assessment Scale (CEAS) were individually used to evaluate atrophic scars and scar erythema based on photographs. Physician-assessed and subject-assessed Global Aesthetic Improvement Scale (GAIS) were used to assess changes before and after FPL treatment. Patient satisfaction and adverse events were also documented. Total mMSS scores, as well as three parameters (color, distortion, and texture), were significantly decreased after FPL treatment, with a mean reduction of 3.18±1.60 in total scores (p<0.05). The CEAS scores were significantly reduced from 2.41±0.98 before treatment to 0.41±0.40 at the final visit (p<0.05). Based on physician-assessed and subject-assessed GAIS scores, 11 (91.7%) patients were improved after FPL treatment. 33.3% of patients were very satisfied, and 41.7% were satisfied. No serious, prolonged (>3weeks) adverse events were observed. Our study suggests that 1064nm FPL treatment may be a promising option for non-acne atrophic scars, especially with scar erythema. Further studies are needed to confirm our results.

Evaluation of Collagen Dermal Filler with Lidocaine for the Correction of Nasolabial Folds: A Randomized, Double-Blind, Multicenter Clinical Trial.

Porcine-based dermal injectable collagen is effective for nasolabial fold correction. In the present study, a new dermal injectable collagen, incorporating a novel cross-linking technology and premixed with lidocaine, was introduced. The study aimed to determine the efficacy of the new dermal injectable collagen in improving bilateral nasolabial fold wrinkles, and reducing pain during injection. This prospective, double-blind, multicenter, parallel-group, randomized trial enrolled participants with moderate-to-severe bilateral nasolabial fold wrinkles from February 2019 to March 2021. Participants were randomly assigned to the test group (new dermal injectable collagen with lidocaine featuring a novel cross-linking technology) or control group (traditionally cross-linked dermal injectable collagen with lidocaine). Participants were monitored for adverse events (AEs), and for pain using the Thermometer Pain Scale (TPS) and a visual analog scale (VAS). Efficacy was measured using the Wrinkle Severity Rating Scale (WSRS) and the Global Aesthetic Improvement Scale (GAIS). On the poor or better sides, the 2 groups exhibited a significant decrease in WSRS scores at 4, 12, 24, and 36 weeks after treatment, compared to baseline WSRS scores (all, p < 0.05). Compared to the control group, the test group had a greater decrease in WSRS score (poor or better sides) at 12, 24, 36, and 52 weeks after treatment (all, p < 0.05). A similar observation was also found in the WSRS response rate and GAIS score of the 2 groups. VAS and TPS scores were not significantly different between the 2 groups (p > 0.05), indicating that pain reduction was similar in the 2 groups. All AEs were anticipated AEs associated with facial aesthetic injections, and most recovered within 0 to 30 days without sequelae. There were no differences in AEs between the 2 groups (all, p > 0.05). The new dermal injectable collagen with lidocaine exhibited better efficacy for correcting nasolabial fold wrinkles compared to the control group. Both relieved pain and produced only transient and tolerable AEs.

Micro-Coring: A Novel Approach to Perioral Rejuvenation.

A long philtrum and poor perioral skin quality are stigmata of the aging face. Micro-coring is a novel technology that allows for scarless skin removal. This study aimed to determine if micro-coring can shorten the philtrum and improve perioral skin quality. A retrospective cohort study was performed on subjects who underwent facelift with perioral micro-coring and age/BMI-matched control patients who underwent facelift alone. Preoperative and postoperative three-dimensional facial imaging was performed. Standard perioral distances and percent change were calculated. Perioral skin quality was evaluated by blinded raters using the Scientific Assessment Scale of Skin Quality (SASSQ) and Global Aesthetic Improvement Scale (GAIS). Thirteen subjects and thirteen controls were included with a mean follow-up of 8.9 months (range 3.0-21.5). Subjects had significantly shorter mean philtral length postoperatively as compared to preoperatively, with an average decrease of 6.18% (±2.25%) (p<0.05). Controls did not experience significant changes in philtrum length (p>0.05). Postoperative philtrum length was significantly shorter in subjects as compared to controls (p<0.05). There were no significant changes in other perioral measurements. Perioral skin elasticity and wrinkles significantly improved in subjects as compared to controls and subjects had significantly greater GAIS scores (p<0.05). Micro-coring can achieve perioral rejuvenation through measurable shortening of the philtrum and observable improvement in skin quality. Non-surgical techniques continue to find new ways to achieve aesthetic goals without significant recovery or scarring and offer value to patients and clinicians.

Intense Pulsed Light (IPL) for thetreatment of vascular and pigmented lesions.

IPL devices emit a wide range of wavelengths that can be absorbed by different chromophores in the skin. Selective destruction of a specific chromophore with minimal side effects is controlled by wavelength, pulse duration, and fluence. This study aims to evaluate the treatment of vascular and pigmented lesions using narrow-band Intense Pulsed Light (IPL) with Advanced Fluorescence Technology (AFT), which offers more efficient energy usage per pulse to increase safety, and improve clinical outcomes. A retrospective analysis of data from 100 patients treated with narrow-band IPL for vascular and pigmented lesions. Efficacy was measured by the Global Aesthetic Improvement Scale (GAIS) and Patient Satisfaction Scale (0-10). Safety was assessed by evaluating pain levels and adverse events. Mean GAIS scores were 8.02 ± 0.84 for vascular and 8.14 ± 0.9 for pigmented lesions with no significant difference between groups (p=0.49, α=0.05). Patient satisfaction correlated with GAIS scores (correlation coefficient 0.8). No pain was reported and two patients experienced temporary and transient side effects. Overall, the advanced IPL treatments provided favorable outcomes for vascular and pigmented lesions.

Three Key Submuscular Points for Nonsurgical Rejuvenation of the Midface in Caucasian Patients: A Methodological Approach Using Injectable Hyaluronic Acid Fillers.

Since aesthetic medical treatments providing natural results are becoming increasingly popular, we developed an innovative hyaluronic acid infiltration technique for midface rejuvenation. In this prospective study, only patients with a negative or neutral lower eyelid vector were included. Treatment consisted in injecting three hyaluronic acid boluses at the cutaneous projections of the levator labii superioris, zygomatic major and minor muscles insertions. All patients were administered before treatment the FACE-Q questionnaire, whereas after treatment, they were administered the FACE-Q questionnaire and the Global Aesthetic Improvement Scale (GAIS). All treatments were documented with standardized photographs. A plastic surgeon from another Institution reviewed the photos and scored the treatments according to the GAIS scale. We included 567 patients (101 males and 466 females) who met the inclusion criteria. The mean age was 41 years, and mean follow-up time was four months. The FACE-Q scores after treatment were significantly higher (p < 0.001) in every domain investigated. The GAIS scores demonstrated significant improvement posttreatment in 89.8% of patients. An average of 1.5 ml of hyaluronic acid (VYC-20) was used for each zygomatic region. No major complications were reported; only 27 patients reported bruising, which resolved spontaneously. In all patients, there was an inversion of the lower eyelid vector, which had transitioned from neutral or negative to positive. Lifting the insertions of three selected muscles with hyaluronic acid allows a midface upward repositioning. This technique provides a reproducible and safe approach for midface rejuvenation through tissue repositioning rather than augmenting facial volume. 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 .

Horizontal necklines correction with absorbable braided polydioxanone threads: Case series.

The prevalence of horizontal neck lines as a cosmetic concern is widely acknowledged, yet the available treatment options are limited, and no studies have investigated the use of polydioxanone-barbed threads. These threads, characterized by a finely braided structure, function as a scaffold to attract regenerative factors and facilitate the migration and proliferation of cells. This study aims to evaluate the outcomes of concurrent application of braided polydioxanone-barbed threads for addressing horizontal neck wrinkles. A retrospective case series involving four female participants (aged 41, 43, 45, and 46) treated with polydioxanone-barbed threads for horizontal neck wrinkles between January 2023 and July 2023 was conducted. Adult patients were assessed at an 8-week follow-up, revealing a significant reduction in wrinkle intensity based on the Horizontal Neck Wrinkle Severity Scale. The analysis of horizontal neck lines demonstrated a notable decrease in wrinkle intensity according to the Horizontal Neck Wrinkle Severity Scale at the 8-week mark, and this improvement maintained statistical significance. Both patient Global Aesthetic Improvement Scale (GAIS) scores (90%-100%) and physician GAIS scores (100%) were rated as excellent. The subdermal application of polydioxanone-barbed threads for horizontal neck lines proves to be a secure and efficacious approach for treating horizontal neck wrinkles, with no observed Tyndall effect. This technique shows promise for rejuvenating the skin in the horizontal neckline region.

Striae Distensae and an Innovative Intradermal Medical Device Based on PN HPT™, Hyaluronic Acid, and Mannitol. A Real-World Insight

Introduction: Striae distensae are often more than a mere skin aesthetic trouble for their impact on self-esteem and as signals of internal medicine disorders like hypercortisolism or cachexia. There is a need to advance in treating striae distensae effectively, particularly their late atrophic hypochromic stage. PN HPT™ may help to restore and preserve a physiologically sound dermal environment. The paper reports the outcomes of a survey study based on an anonymous questionnaire. The study’s purpose was to confirm the long-term effectiveness and safety profile of an intradermal medical device based on PN HPT™ (1 mg/mL), HA (1 mg/mL), and mannitol ) within a multi-year clinical monitoring program. Methods: The investigators — dermatologists and plastic and aesthetic surgeons — carried out the study in real-world subjects, all of them women, who spontaneously sought office treatment to improve skin quality in areas of subjectively grievous striae distensae and striae albae—a total of 38 lesions. All investigators had already used the investigated intradermal device for short-term treatment and long-term maintenance. All surveyed subjects had undergone a cycle of six to eight intradermal injection sessions over three months to improve the texture of their striae distensae—a once-weekly injection for the first month and one injection every two weeks for the last two months with a tolerance of two missing injections. Assessment tools and timing: Global Improvement Scale (GIS) and Global Aesthetic Improvement Scale (GAIS) two to four weeks after the end of the treatment period. Results: At the follow-up visit, the investigators evaluated that, globally (mean GIS scores), 50.0% and 47.4% of the treated striae distensae showed moderate improvement or were much improved compared with the baseline. The corresponding outcomes for the independent evaluator were 55.3% and 44.7%. The local skin quality and texture in the lesion areas (mean GAIS scores) appeared to have improved or to be much improved by 50.0% and 50.0% according to investigators, and by 42.9% and 57.1%, respectively, according to surveyed patients, with no reported side effects. Conclusion: The real-world monitoring survey demonstrated that the NEWST ONE medical device based on PN HPT™, HA, and mannitol as an inhibitor of HA metabolism retains its long-standing record of efficient performance and excellent safety with no variations over time.

Full-face and neck resurfacing with a novel ablative fractional 2910 nm erbium-doped fluoride glass fiber laser for advanced photoaging.

Ablative fractional lasers have long been considered the gold standard for facial resurfacing for advanced photoaging. These lasers offer an improved safety profile compared to traditional ablative lasers but typically require more treatment sessions given their fractional approach. In this study, we evaluate a new novel 2910 nm erbium-doped fluoride glass fiber laser (2910 nm fiber laser) (UltraClear; Acclaro Medical) for full-face and neck resurfacing for the treatment of advanced photoaging. Twenty-two healthy subjects aged 44-80 years presenting for advanced facial photoaging and rhytides were enrolled in the study. All subjects received three full-face and neck, multipass treatments utilizing the 2910 nm fiber laser spaced 6-8 weeks apart. Subjects were asked to rate the average level of pain during the treatment. At 90 days following subjects' third treatment subjects evaluated their improvement using a Global Aesthetic Improvement Scale (GAIS) and rated their satisfaction with the treatment. Evaluation of pretreatment and posttreatment photos was completed by two blinded physician reviewers. Reviewers were asked to identify the pretreatment and posttreatment photographs and to rate the degree of improvement utilizing a GAIS. Fifteen participants completed the study; six were exited from the study (withdrew or lost to follow-up). The average subject GAIS score for overall appearance was 3.8. The average subject satisfaction level at follow-up was 4.8. The average subject pain score was 4.9. One blinded physician reviewer correctly identified 100% of subjects' posttreatment photographs, while the second blinded reviewer correctly identified 93%. Blinded evaluation of digital photographs revealed an average GAIS score of 3.2. Posttreatment skin responses included pin-point hemorrhage, erythema, edema, and soft tissue crusting lasting 5-7 days. There were no instances of infection, scarring or hypopigmentation. There were two instances of temporary hyperpigmentation. Treatment with the novel 2910 nm fiber laser is safe and effective in treating advanced photoaging and rhytides. Three treatments produced moderate to marked improvement with high patient satisfaction and treatment was associated with less discomfort and downtime compared to conventional fractional ablative lasers.

Safety and Efficacy of High-Intensity Focused Ultrasound and Monopolar Radiofrequency Combination Therapy for Skin Tightening: A Retrospective Study in Malaysia.

High-intensity focused ultrasound (HIFU) and monopolar radiofrequency (MRF) are common treatment modalities that have shown significant results in skin tightening. Nevertheless, the novel combination of these two treatments is new to the Malaysian landscape. Thus, this study aims to investigate the safety and efficacy of this novel combination treatment for the Malaysian population. This retrospective study included data on HIFU and MRF combination therapy for skin tightening collected from an aesthetic clinic in Johor Bahru, Malaysia from June 2018 to May 2021. Efficacy was assessed using the Global Aesthetic Improvement Scale (GAIS) and Glogau classification, while the safety of the treatment was analysed using pain scores and adverse events (AEs). A total of 56 patients with a mean age of 47.7 years old (SD 10.00) were included in this study. The majority of the patients had Fitzpatrick skin types III and IV. Most of the patients were Chinese, followed by Malay, Indian and others. Most patients (96.4%) showed clinically significant improvement in skin tightening after treatment, with 15 patients scoring 1 (very much improved) and 39 scoring 2 (improved). All patients reported transient mild erythema, with no serious AEs, such as burn, swelling, numbness or muscle weakness. Among the patients, 80% reported a pain score of 5, while 10% reported pain scores of 4 and 6. Combining HIFU with MRF therapy improved GAIS scores by 96.4%, indicating a secure and efficient skin-tightening method. Transient erythema was shown to be the most common side effect of this combination.

Efficacy and safety of fractional microneedle radiofrequency for atrophic acne scars: A real-world clinical study of 126 patients.

To analyze the clinical efficacy and safety of fractional microneedle radiofrequency (FMR) for facial atrophic acne scars in a real-world setting. The clinical data of patients with atrophic acne scars who had received FMR therapy from February 2018 to August 2022 were retrospectively analyzed. The improvement of atrophic acne scars was assessed using the ECCA Grading Scale (échelle d'évaluation clinique des cicatrices d'acné), Global Aesthetic Improvement Scale (GAIS), and modified Manchester Scar Scale (mMSS). Adverse reactions during FMR treatment were also recorded. Univariate and multivariate logistic regression analyses were performed to evaluate the efficacy and safety of FMR for atrophic acne scars. A total of 126 patients with facial atrophic acne scars were included. A total of 590 FMR treatment sessions were accomplished, with each of 82 patients receiving 4 or more treatment sessions, and 1 receiving a maximum of 14 sessions. All patients showed improvement in symptoms after FMR treatment, with moderate to significant improvement (ECCA score reduction of 26%-100%) in 92 (73.0%) patients. As the number of treatment sessions increased, the ECCA score gradually decreased from an average of 85.6 before to 35.0 after FMR. The average scores for distortion, color, and visual analogue scale (VAS) of mMSS all showed certain reductions. The change in GAIS score indicated improvement after treatment, with minimal improvement in 16 patients (12.7%), good improvement in 57 patients (45.2%), significant improvement in 45 patients (35.7%), and optimal improvement in 8 patients (6.4%). The univariate and multivariate logistic regression analyses revealed that the long pulse width and the number of FMR treatment sessions were positively associated with clinical efficacy. Compared to the short pulse-width group (200 ms), the longer pulse-width group (300 ms) (odds ratio [OR] = 8.3, p = 0.003) and the even longer pulse-width group (400-500 ms) (OR = 52.6, p < 0.001) demonstrated stronger efficacies. Patients who received more than three treatment sessions had better outcomescompared to those who received three or fewer treatment sessions (OR = 4.0, p = 0.036). All patients experienced posttreatment transient erythema, but no crusting, infection, or blister. Six cases developed grid-like erythema around 1 month posttreatmentand one case experienced hyperpigmentation, both of which resolved within 1-3 months after appropriate management. FMR is a safe and effective treatment modality for improving facial atrophic acne scars, and the number of FMR treatment sessions and pulse width are associated with clinical efficacy.

Clinical efficacy of stromal vascular fraction gel in the treatment of mature striae distensae.

Striae Distensae (SD) is a common dermatological lesion. The mechanism of formation is unclear, the prevailing theory is mechanical pulling of the skin and hormonal changes. Traditional SD treatment methods include topical drugs, photoelectric therapy, stripping and others, but each has limitations. Stromal vascular fraction gel (SVF-gel) is a filler physically prepared from granular fat, enriched with adipose-derived stem cells (ADSCs) and extracellular matrix (ECM). A good effect in the treatment of neck lines, wounds, acne, and other aspects. SD formation and treatment goals are comparable to those of neck lines. In this study, SVF-gel filling will be used to treat mature SD, and its effectiveness and safety will be discussed in detail. From December 2019 to June 2022, recruit patients who want to treat SD caused by obesity or pregnancy among those who have "autologous fat aspiration" to change their body shape. Preoperatively, the area to be treated for SD was marked, autologous fat aspiration was performed, and the aspirated fat was prepared as SVF-gel and filled into the preoperatively marked SD. All patients had preoperative and postoperative follow-up with planar photographs and VISIA skin analyzer photographs to assess surgical results and safety from subjective and objective perspectives. A total of 36 patients were enrolled, with 31 of them successfully followed up on. The mean Global Aesthetic Improvement Scale (GAIS) score six months after surgery was 1.87±0.03. At six months postoperatively, the overall patient satisfaction rate was 90%. The depth, area, and colorof SD improved six months after surgery, and no serious complications occurred in any of the patients. SVF-gel is a safe and effective method of improving mature SD and can be used as a clinical treatment option.

Safety and Efficacy of Using MaiLi® Precise by Mean of Intradermal Injections for Correcting Perioral Fine Lines

Introduction: Over the last twenty years, dermal fillers have become the backbone for rejuvenating the perioral area, which is one of the most difficult areas to treat. Due to the development of highly sophisticated fillers with radically different rheological properties and innovating techniques, it has become possible to correct specific regions with more natural results than before. This four-center pilot study sought to investigate the efficacy and safety of MaiLi® Precise in correcting fine-line wrinkles of the perioral area. Material and Methods: MaiLi® Precise is a recently introduced Hyaluronic Acid (HA) filler, harnessing the OxiFree™ technology, for suppleness, flexibility, and high longevity. These properties were deemed particularly suitable for correcting fine-line perioral wrinkles. All injections were performed using intradermal injections, with the fluid HA injected in a very superficial manner, resulting in the formation of very small papules at the wrinkle, disappearing within 1-2 hours. Follow-up occurred at one (T1) and three months (T2) post-injection. Treatment effectiveness was evaluated using the Global Aesthetic Improvement Scale (GAIS), as was the satisfaction of the subjects and investigators. Adverse Events (AEs) were also reported. Results: Overall, 20 patients aged 56 years on average, from four centers, were injected MaiLi® Precise into the perioral area to correct perioral lines using intradermal injections. No specific safety concerns were detected, given that AEs remained mild, were almost all resolved by T1, and were completely absent by T2. Patient and physician satisfaction were both &gt;90% during follow-up. All physicians attributed improved, much improved, or very much improved GAIS scores at T1 and T2, indicating a marked improvement in appearance after injection. Conclusion: Based on the current study results, MaiLi® Precise was shown to be safe and provided satisfactory results from both the patient and the physician’s points of view during a 3-month follow-up.

Global facial rejuvenation with one treatment of incobotulinumtoxinA, hyaluronic acid, and calcium hydroxyapatite results in long-term patient-reported satisfaction.

Global facial rejuvenation using injectables (neuromodulators and fillers) has reported patient satisfaction after 2 treatments: an initial and touch-up treatment at 2-4 weeks afterward. In practice, patients typically receive only 1 treatment and do not return for a touch-up treatment within a month. The purpose of this study was to assess patient-reported satisfaction after only 1 treatment, thus mimicking real-world scenarios. Patients with facial photoaging (Glogau facial aging scale ≥2) were treated with calcium hydroxyapatite, hyaluronic acid 22.5 mg/mL, and incobotulinumtoxinA injections for full facial rejuvenation, with no touch-up treatments. Patients completed the FACE-Q Satisfaction with Facial Appearance survey at baseline and 1- and 3-month post-treatment. The treating physician completed the Global Aesthetic Improvement Scale at 1- and 3-month post-treatment. Twenty-two patients were enrolled in the study, with 1 patient lost to follow-up. There was a significant improvement in mean FACE-Q scores at 1-month (80.1, P = .01) and 3-month (77.9, P = .02) compared to baseline (71.4). Mean Global Aesthetic Improvement Scale scores at 1-month (2.1) and 3-month (2.2) were not statistically significant, indicating sustained improvement at 3 months. The product amount used per patient varied and was not correlated with either score. Limitations included a lack of a control group and follow-up ending at 3 months. Strengths included assessment of patient satisfaction after only 1 treatment, compared to other studies allowing 2 treatments. Limitations include a small sample size and lack of a control group. Global full facial rejuvenation using 1 treatment of calcium hydroxyapatite, hyaluronic acid 22.5 mg/mL, and incobotulinumtoxinA provides sustained patient-reported satisfaction at 3 months.

Striae distensae treatment: evaluating laser efficacy and safety.

Striae distensae (SD) are common skin lesions that are difficult to treat and affect quality of life. Laser and light are emerging non-invasive therapies that have proven successful in treating SD. Recently, hybrid laser devices offering simultaneous fractional ablative and non-ablative laser treatment have been reported to benefit various skin conditions. To evaluate the improvement of SD treated with a hybrid laser system and to analyze associations with patient characteristics. We performed a retrospective study in which 28 adults with SD were treated with a hybrid laser device. Efficacy was evaluated by the assessment of aesthetic improvement by the Global Aesthetic Improvement Scale (GAIS) of 1-10 and by patients' satisfaction using a scale of 0-10 satisfaction scale. Pain and adverse events were monitored. Statistical analysis was used to examine the potential impact of various factors on treatment outcomes. The mean GAIS score was 7.36 ± 1.06 with a positive correlation with patient satisfaction (r = 0.685) and a weak negative correlation with patient age (r = -0.0057). Skin type and body area did not show significant associations with GAIS scores (P > 0.05 for both). No adverse events were observed. This study demonstrates the potential of the hybrid laser system as a safe and effective method to achieve satisfactory aesthetic results with minimal downtime, making it a promising treatment approach for SD. Treatment outcomes were independent of patient characteristics, further supporting its widespread use.

Infraorbital Rejuvenation Combined with Thread-Lifting and Non-cross-linked Hyaluronic Acid Injection: A Retrospective, Case-Series Study

BackgroundInfraorbital aging develops during the natural aging process. Various treatment options offer unique benefits, accompanied by diverse side effect profiles, and can be synergistically combined to optimize results. This study aimed to evaluate the efficacy of a comprehensive approach involving non-cross-linked hyaluronic acid injection and smooth absorbable PPDO (poly p-dioxanone) thread insertion for infraorbital rejuvenation.MethodsThis retrospective case series study enrolled ten female patients with infraorbital aging from March 2022 to April 2023. Clinical outcomes, patient satisfaction, and adverse events were assessed at 1, 3, and 6 months posttreatment.ResultsThe median Global Aesthetic Improvement Scale scores evaluated by the operator and blinded evaluator were 1.70 ± 0.42 and 1.80 ± 0.35, respectively, at six months posttreatment. The median Allergan Infraorbital Hollows Scale determined by the operator was 1.15 ± 0.34 at six months posttreatment, whereas the scores evaluated by the blinded evaluator were 1.15 ± 0.53. At six months after treatment, 50% of patients were satisfied, and an additional 40% reported strong satisfaction with the clinical improvement following treatment. No serious adverse events, such as infections, lumps, irregularities, Tyndall effect, hematoma, or skin necrosis, occurred during the treatment period.ConclusionsThe combination of PPDO thread insertion and non-cross-linked hyaluronic acid injection yielded satisfactory and effective clinical outcomes with no occurrence of serious adverse events for infraorbital rejuvenation. We anticipate that this study will contribute to the advancement of novel treatment options for infraorbital aging.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Clinical application of 675nm laser therapy for dorsal hand skin hyperpigmentation.

Noninvasive skin rejuvenation treatment is growing in recognition to aesthetic medicine. The objective of the study was to assess the efficacy and the safety of the 675-nm laser source treatment of photodamaged hands. The study included 21 patients (6 males and 15 females) with a mean age of 63(±9) years. Patients were treated with -two to three sessions of the 675-nm laser with a 1-month interval between sessions. Photos of each patient were collected at baseline, and 3 months after the last laser session. The 5-point Global Aesthetic Improvement Scale (GAIS) was recorded with their final assessment session (3 months). The total GAIS scores showed satisfactory results: 15 patients (71%) experienced 4 score (excellent improvement) changes and 6 patients (29%) experienced 3 score (good improvement) changes. Clinical images showed good efficacy and visible aesthetic results for the management of photodamaged skin. No serious adverse effects were recorded. This study demonstrates the safety and efficacy of for the aesthetic improvement of skin pigmentation and texture for photodamaged hands.

Using the depth deviation based on three-dimensional images to evaluate the correction of nasolabial folds: A prospective and quantitative analysis.

The deepening of the nasolabial fold (NLF) is a common occurrence during the aging process, necessitating the development of an objective method to evaluate changes in NLFs. The objective of our study was to introduce a method of depth deviation based on three-dimensional (3D) image for evaluating the efficacy of hyaluronic acid (HA) injection in correcting NLFs. Between May 2019 and November 2019, we recruited 56 Chinese volunteers with moderate to severe NLFs for this study. The participants received HA injections and were followed up for a period of 12 months. Pre and posttreatment, we collected the Wrinkle Severity Rating Scale (WSRS) scores and 3D images. To assess the efficacy of NLF correction, we used the maximum value of depth deviation (MVD) based on 3D images and the Global Aesthetic Improvement Scale (GAIS) score. Additionally, we compared the relationship between MVD and other clinical parameters. Fifty-four female participants completed the study and were included in the analysis. The HA injection resulted in a significant decrease in NLF severity (p < 0.05). One month after the injection, the average GAIS score was 4.72 ± 0.45, and the average MVD was 2.10 ± 0.56 mm. Both the GAIS score and the average MVD exhibited a decline over time during the follow-up period, with the average MVD showing a significant correlation with the GAIS score at all time points (p < 0.05). Using 3D technology, we demonstrated that the quantitative data provided by MVD can serve as an objective method for evaluating the correction of NLFs.

Improvement in facial aesthetics of orthognathic patients after surgery-first approach

Facial appearance significantly affects psychosocial wellbeing, and an improvement in facial aesthetics is considered an essential outcome of orthognathic treatment. The surgery-first approach (SFA) has emerged as a promising alternative to the conventional orthodontics-first approach (OFA) due to its potential advantages in reducing treatment duration and cost, delivering early aesthetic improvement, and increasing patient satisfaction. However, its impact on final facial aesthetics and how it compares with the OFA has, to our knowledge, not yet been investigated. This retrospective study aimed to compare the improvement in facial aesthetics after orthognathic surgery in an SFA and an OFA group. Preoperative and postoperative 3-dimensional stereophotogrammetry facial images of 40 patients were evaluated by five professional assessors using the Global Aesthetic Improvement Scale (GAIS). Similar aesthetic improvement outcomes were found in both the SFA and OFA groups. The GAIS score significantly correlated with the following facial variables: upper lip projection, chin prominence, facial proportions, paranasal hollowing, lip competence, mandibular projection, and facial profile. No significant correlation was found between a change in aesthetic score and the surgical variables. There was a positive association between overall GAIS score and the gender and experience level of the individual assessors. This study suggests that aesthetic facial improvement achieved with the SFA is satisfactory and comparable to that of the OFA.