Medical Aesthetic Procedures Research Articles

Zinc in Dermatology: Exploring Its Emerging Role in Enhancing Botulinum Toxin Formulations and Clinical Efficacy

This literature review provides a novel exploration of zinc’s multifaceted roles in dermatology, with a particular focus on its potential integration into botulinum toxin formulations—an area that remains relatively underexplored in clinical practice. Zinc is widely recognized for its critical functions in skin health, including morphogenesis, regeneration, and protection, and its use in aesthetic medicine offers a unique opportunity for innovation. Specifically, incorporating zinc into botulinum toxin formulations could enhance the efficacy and stability of these treatments. Although zinc has historically been used in topical dermatological products and systemic health interventions, its potential in cosmetic preparations, such as anti-aging therapies or non-invasive aesthetic treatments, remains under-researched. Emerging patents suggest promising formulations combining zinc with botulinum toxin that may improve product stability and extend therapeutic effects. While current studies on oral zinc supplementation present mixed results concerning its ability to prolong botulinum toxin effects, this underscores the need for more rigorous investigation in the realm of aesthetic medicine. Zinc’s well-established role in stabilizing dermatological products, such as sunscreens, and its applications in wound healing and skin regeneration, further highlights its potential for broader therapeutic uses beyond cosmetic applications. This review identifies a critical gap in the literature and calls for future research to optimize zinc concentrations and delivery methods specifically for aesthetic medical procedures, offering new insights into improving dermatological treatments beyond the scope of traditional cosmetic preparations.

Real-World Experience Using a Multi-Modality System using Intense Pulsed Light, Radiofrequency Microneedling, High-Intensity Focused Ultrasound, or Thermal Radiofrequency, 808, HIFU for Skin Rejuvenation Treatment.

Medical aesthetic procedures for facial rejuvenation with laser and energy-based devices (EBDs) are rapidly increasing. The following cases highlight real-life experience using a multi-modality system with various handpieces that combine intense pulsed light (IPL), laser hair removal (808 diode), high-intensity focused ultrasound (HIFU), radiofrequency microneedling (RFM), and thermal radiofrequency (RF) for antiaging and rejuvenation treatment. Laser and RFM treatments may improve skin conditions by inducing cutaneous changes that remodel the skin matrix. Six physicians who treat patients for skin rejuvenation reported on clinical cases from their practice using a multi-modality system with various handpieces. During the meeting, the advisors discussed 15 cases and agreed to select seven patients with different ages and skin phototypes receiving various treatments for photodamage of the face, neck, and décolleté. The advisors discussed why they selected the case, previous treatment, type of treatment, results, and clinical pearls. Sharing best practices in medical aesthetics using combination treatments on a single multi-modality energy-based device such as laser and MRF for facial, neck, and chest skin may support healthcare providers treating patients for skin rejuvenation to improve clinical outcomes.

Complications associated with needle-based medical aesthetic procedures: clinical and medico-legal aspects from the Polish perspective

Complications associated with needle-based medical aesthetic procedures: clinical and medico-legal aspects from the Polish perspective

Long-term Implications of Cosmetic Breast Surgeries on Subsequent Breast Reconstruction.

Cosmetic breast surgeries, such as augmentation, mastopexy, and reduction, are common aesthetic medical procedures for enhancing physical appearance. Despite their popularity, the influence of these surgeries on subsequent breast reconstruction for cancer patients remains underexplored. This study seeks to investigate the effects of previous cosmetic breast surgeries on the outcomes of breast reconstruction. A retrospective chart review was conducted from January 2011 to May 2023. This analysis compared patients with histories of implant augmentation, breast reduction, mastopexy, and augmentation-mastopexy against those receiving reconstruction without any cosmetic surgery history. Demographics, comorbidities, complications, revisions, and BREAST-Q surveys were collected. Statistical analysis was performed using SPSS, with significance set at p<0.05. The study included 124 patients (50 autologous, 74 implant) with a history of cosmetic breast surgery (102 implant augmentations, 17 breast reductions, five mastopexies, and nine augmentation mastopexies). They were analyzed against 1307 patients (683 autologous, 624 implant) without prior cosmetic breast surgery. Patients with prior cosmetic surgeries showed a higher incidence of hematoma with tissue expander placement. A preference for implant-based reconstruction was more common among patients with augmentation history (p<0.001), whereas autologous reconstruction was more common in those with history of breast reduction (p=0.047). Patients with history of breast augmentation had on average significantly more breast revisions (p <0.05). This study demonstrates a significantly higher hematoma rate and number of revisions compared to patients without a history of cosmetic surgery. Furthermore, it suggests that types of cosmetic breast surgery influence the decision-making process regarding implant versus autologous reconstruction.

A Practical Algorithm for Integrating Skincare to Improve Patient Outcomes and Satisfaction With Energy-Based Dermatologic Procedures.

Medical aesthetic procedures for facial antiaging with laser and energy-based devices (EBDs) are rapidly increasing, but standards integrating skincare before, during, and after these treatments are lacking. The algorithm for integrated skin care for facial antiaging treatment with EBDs aims to stimulate healing, reduce downtime, and improve comfort and treatment outcomes. A panel of 8 global physicians employed a modified Delphi method and reached a consensus on the algorithm integrating skincare based on the best available evidence, the panel's clinical experience, and opinions. The algorithm has a pretreatment (starts 2 - 4 weeks before the procedure) and treatment (day of treatment) section, followed by care after the procedure (0 - 7 days) and follow-up care (1 - 4 weeks after the procedure or ongoing). Applying a broad-spectrum sunscreen with an SPF 50 or higher, combined with protective measures such as wearing a wide-brimmed hat and sunglasses, is recommended to protect the face from sun exposure. Dyschromia is a significant concern for those with skin of color (SOC). Clinicians may recommend skincare using a gentle cleanser and moisturizer containing vitamins C and E, retinoid, or other ingredients such as niacinamide, kojic acid, licorice root extract, azelaic acid, and tranexamic acid, depending on the patient's facial skin condition. Medical aesthetic procedures for facial antiaging with EBDs integrating skincare or topical treatments may improve outcomes and patient satisfaction. Topical antioxidants and free radical quenchers can combat photodamage and may offer a safe alternative to topical hydroquinone.&nbsp; J Drugs Dermatol. 2024;23(5):353-359.&nbsp; &nbsp;&nbsp; doi:10.36849/JDD.8092.

A Practical Algorithm Integrating Skin Care With Nonenergy and Injectable Dermatologic Procedures to Improve Patient Outcomes and Satisfaction.

The most rapidly increasing medical aesthetic procedures for facial antiaging comprise nonenergy and injectable treatments. Currently, standards for skin care before, during, and after nonenergy and injectable treatments are lacking. The algorithm on supportive skin care for facial antiaging nonenergy and injectable treatments aims to stimulate healing, reduce downtime, and improve comfort and treatment outcomes.&nbsp; Methods: A panel of 7 global physicians employed a modified Delphi method and reached a consensus on an algorithm for supportive skin care for nonenergy and injectable antiaging treatments based on the best available evidence and the panel members&rsquo; clinical experiences and opinions. The algorithm has a pretreatment (starts 2 &ndash; 4 weeks before the procedure) and treatment or ongoing (day of treatment) section, followed by care after the procedure (0 &ndash; 7 days) and follow-up care (1 &ndash; 4 weeks after the procedure). Applying a broad-spectrum sunscreen with an SPF 30 or higher, combined with protective measures, such as wearing a wide-brimmed hat and sunglasses, is recommended to protect the face from sun exposure. Dyschromia is a significant concern for those with richly pigmented skin. Clinicians may recommend skin care using a gentle cleanser and moisturizer containing vitamins C and E, retinoid, or other ingredients, such as niacinamide, kojic acid, licorice root extract, azelaic acid, and tranexamic acid, depending on the patient's facial skin condition. Nonenergy and injectable procedures combined with skin care or topical treatments may improve outcomes and patient satisfaction. Topical antioxidants and free radical quenchers can combat photodamage and may offer a safe alternative to topical hydroquinone.&nbsp; &nbsp; J Drugs Dermatol. 2024;23(4):&nbsp; &nbsp; &nbsp;doi:10.36849/JDD.7918.

Application of integrated skincare in medical aesthetics: A literature review.

Integrated skincare combines clinically proven skincare products with professional medical aesthetics to provide a comprehensive solution for beauty pursuers. Studies have demonstrated that a combination of medical aesthetic procedures and maintenance therapies is more effective than either treatment alone. This review outlines the current applications of integrated skincare, including different regimens of energy-based aesthetic devices and active ingredients in cosmeceuticals or chemical peels. Additionally, the benefits and limitations of integrated skincare are discussed. Lastly, this review highlights the potential for improved satisfaction and long-term maintenance of the desired outcomes through appropriate integrated skincare procedures.

Facility Recommendations for Medical Aesthetic Procedures in Canada.

This article articulates core facility recommendations for regulated health care providers and professionals performing medical aesthetic procedures involving the use of topical and local anesthesia in a private clinic setting in Canada. The recommendations help ensure patient safety, confidentiality, and ethics. Information is provided about the setting/environment where medical aesthetic procedures are performed, safety equipment and emergency medications that should be on-site for medical aesthetic procedures, infection prevention and control measures, the way that medications and medical supplies should be stored, how to handle biomedical hazardous waste, and how to protect patient information.

Ophthalmic Complications after Needle-Based Medical Aesthetic Procedures: A Narrative Review.

This study aimed to discuss common complications of medical aesthetic treatments, which require ophthalmological intervention. This literature study evaluated published journal articles (clinical trials or scientific reviews) that were extracted from electronic databases (MEDLINE and PubMed) and reference lists of related articles. Only articles available in English were considered for this review. Unskillful interference in the eye area can cause severe, irreversible complications, including blindness. This is a constant risk because of anatomical deviations, and retrograde blood flow. Accurate knowledge of anatomy, especially the vascular anatomy of high-risk sites, and the understanding of the depth and plane of injection, and various injection techniques minimize the risk of these complications.

Bilateral Gluteal Augmentation With Hyperdilute Calcium Hydroxylapatite Microspheres Performed Using the Bella Vida Instant Brazilian Butt Lift (BBL)™.

For decades, aesthetic medical procedures have sought to improve patient appearance, comfort, and self-confidence. In more recent years, a growing interest in body contouring cosmetic procedures has emerged, in large part due to increased transparency in procedures and improved outcomes with minimally invasive procedures. Notably, several biostimulatory fillers have emerged as a suitable treatment modality due to their relatively low cost, low pain, short downtime, high tunability, and sustained biostimulatory effect. One volumizing biostimulatory filler, Radiesse® (Merz Aesthetics, Frankfurt, Germany), consists of calcium hydroxylapatite microspheres suspended in a carboxymethyl cellulose gel. When injected, Radiesse immediately volumizes the injection site and initiates neocollagenesis and neoelastogenesis. One technique, the Bella Vida Instant Brazilian Butt Lift (BBL)™, is a fast, safe, and minimally invasive alternative to surgical gluteal augmentation that accomplishes morphological remodeling, increases volumization, and improves shape and patient satisfaction. This technical report provides the clinical basis, materials, and methods for implementing the Bella Vida Instant BBL™ in aesthetic practices.

Platelet-rich plasma: how safe is it, and can it cause irreversible blindness?

Platelet-rich plasma (PRP) is not a new treatment. It has been around for a long time, but it is still very much misunderstood and there are many unanswered questions about it. It is known that it is autologous, meaning that it comes from the patient's own body, and, therefore, allergic reactions cannot occur to one's own blood and the body will not reject it. Despite this, questions still remain around whether it is completely safe. There are several articles that briefly touch on the safety of PRP, but they do not delve into the topic deep enough. As clinicians already know from other medical aesthetic procedures, none are 100% safe and they all come with potential risks and complications. Therefore, it is worth asking whether PRP is any different.In this article, the author discusses PRP from a safety perspective and dissects three clinical papers that highlight that there have been six reported cases of blindness from this treatment.

Social Profiloplasty: A Practical Assessment and Injection Guide.

The trend of aesthetic medical procedures continues growing every year since decades all over the globe, especially considering minimal invasive treatments since the results are immediate and the downtime minimal. Hence, treatments with hyaluronic acid fillers have become extremely popular and routinely used in common practice. However, numerous areas of treatment were identified and described in the last years clinical training and consciousness of possibly complication remain still under represented. In the following article, we present four key treatment areas for optimal overall facial rejuvenation of what the authors define the social profile. Of each area an assessment, anatomical considerations, danger zones, and the preferred personal technique of the authors are described.

Termo de consentimento informado: impacto na decisão judicial

Resumo O termo de consentimento informado é fundamental na relação jurídica entre médico e paciente. Visando avaliar seu impacto na sentença judicial, realizou-se estudo retrospectivo de 70 processos de responsabilidade civil envolvendo procedimentos médicos estéticos cirúrgicos e não cirúrgicos com termo de consentimento assinado pelos pacientes. Os casos analisados, julgados entre 2014 e 2016, foram selecionados nos sites dos tribunais brasileiros e classificados em dois grupos: médicos absolvidos (51%) e condenados (49%). No primeiro grupo, 39% das absolvições se embasaram na apresentação adequada do termo de consentimento informado, enquanto, no segundo, 50% dos médicos foram condenados por não o ter incluído. Portanto, o termo de consentimento informado se destaca nos julgamentos de erro médico. O dever de informar é um dos pilares da responsabilidade civil desse profissional e, quando negligenciado, constitui fator substancial para condenação.

Two multinational, observational surveys investigating perceptions of beauty and attitudes and experiences relating to aesthetic medical procedures.

BackgroundData on opinions and experiences of aesthetic medical procedures outside the United States and Western Europe are scarce.AimsThis study aimed to survey users and non‐users of aesthetic procedures in countries where this information is less readily available, to understand attitudes and perceptions relating to beauty.Patients/MethodsTwo independent internet‐based observational surveys were conducted. Survey 1: individuals from Colombia, Lebanon, Malaysia, Russia and Turkey who were ‘users’ or ‘non‐users’ of aesthetic medical procedures. Survey 2: individuals from Colombia, Russia, Thailand, Turkey and the United Arab Emirates who were ‘users’ of non‐surgical aesthetic treatments.ResultsSurveys 1 and 2 were completed by 300 and 160 individuals, respectively, most of whom were female (94.0% and 99%). Overall, respondents rated the eyes and smile as the most pleasing male and female facial features. Most participants (mean 82.6%; range 75%‐100%) believed maintaining a healthy lifestyle was important for ageing gracefully, and over one‐third (36.0%; 28%‐47%) believed men age more gracefully than women. The emphasis respondents placed on the importance of physical attributes vs inner feelings, internal beauty and self‐confidence varied between countries. Users were often more positive about aesthetic medical procedure outcomes than non‐users. Adequate information, good physician communication (including managing treatment expectations), treatment recommendations based on patient need and good aftercare improved treatment satisfaction.ConclusionsThe eyes and smile were key features of attractiveness, but maintaining a healthy lifestyle was consistently considered an important factor for ageing gracefully. Ensuring patients are well informed was a major determinant of treatment satisfaction.

No More Taboo: Discursive tactics for navigating the taboo of cosmetic surgery

Traditionally, in many places around the world, cosmetic surgery is is framed as artificial, man-made, and socially unacceptable. The Korean Wave produces K-pop, K-beauty, and K-fashion, the Korean Wave “Hallyu” has spread rapidly across the globe bringing with it new values about the acceptability of cosmetic surgery and what is considered beautiful and desirable. As a result, cosmetic surgery is now a major export for Korea. This study examines how the Korean aesthetic medical industry and how medical tourists from Hong Kong and Mainland China consume Korean culture and promotional material related to aesthetic medical procedures and in some cases overcome deeply held taboos about cosmetic surgery prevalent in Chinese culture. We find that while Hallyu and the prevalence of social media has indeed influenced consumers standards of beauty, both promoters and consumers of Korean aesthetic medicine must actively work to build the discursive resources to overcome both taboos and perceived risks of undertaking such procedures. Some of the risks and taboos that users actively address include the potential medical risk of cosmetic surgery itself, the social acceptance risk (being judged by friends, family, and the community), and existential risk - admitting that one is ugly or unworthy or that one’s identity may change or completely cease to exist after such a procedure.

Addiction to medical aesthetic procedures

Today’s media disseminate a narcissistic cultivation of beauty and promote a focus mainly on appearance and satisfaction from its improvement. The human body assumes a form in the media that is often impossible to achieve without surgical intervention. When people are in frequent contact with a utopian vision of the perfect body, this can lead to many disorders in both social functioning and self-perception. In extreme cases, striving to preserve beauty and youth may lead to an addiction to aesthetic medicine treatments. It is an increasingly common phenomenon. People who are addicted to treatments improving their beauty or changing their body shapes are not aware of the problem that affects them. They lose their rational judgement and their assessment is far from the opinions of people around them and socially accepted norms. All signs of concern from others are perceived as an attack on their independence and this further deepens their sense of loneliness and isolation from society. With time, undergoing further beautifying procedures becomes the only way they know to achieve a momentary sense of happiness.

Body dysmorphic disorder and addiction to medical aesthetic procedures

According to the Diagnostic and Statistical Manual of Mental Disorders, body dysmorphic disorder (BDD), or dysmorphophobia, is the preoccupation with an imagined defect in appearance that leads to significant distress and impairments to daily functioning. Due to their lack of insight, individuals with BDD believe that cosmetic procedures will be the solution to their insecurities, even though they rarely get satisfaction from them. Cosmetic procedures can then become an addiction, as patients never reach full satisfaction. In response to this issue, aesthetic practitioners need to identify those presenting with BDD by administering a questionnaire that asks how many cosmetic surgeries the individual has had previously, before continuing with any aesthetic procedure. Those who show signs of BDD can then be referred to mental health professionals for specialised treatments, such as medications, cognitive behavioural therapy, exposure and response prevention, and family support.

Avoiding Psychological Pitfalls in Aesthetic Medical Procedures.

To assess the prevalence of body dysmorphic disorder (BDD) in an aesthetic surgery setting in the region of Southwest China, and to ascertain the differences in terms of body images between patients in the aesthetic setting and general Chinese population. This study tracked patient satisfaction with their body image changes while undergoing aesthetic medical procedures to identify whether the condition of patients who were presenting with BDD symptoms or their psychological symptoms could be improved by enhancing their appearance. Additionally, this study explored whether there was improvement in quality of life (QoL) and self-esteem after aesthetic medical procedures. A total of 106 female patients who were undergoing aesthetic medical procedures for the first time (plastic surgery, n=26; minimally invasive aesthetic treatment, n=42; and aesthetic dermatological treatment, n=38) were classified as having body dysmorphic disorder symptoms or not having body dysmorphic disorder symptoms, based on the body dysmorphic disorder examination (BDDE), which was administered preoperatively. These patients were followed up for 1month after the aesthetic procedures. The multidimensional body self-relations questionnaire-appearance scales (MBSRQ-AS) and rosenberg self-esteem scale (RSE-S) were used to assess patients' preoccupation with appearance and self-esteem pre-procedure and 1month post-procedure. Additionally, 100 female healthy control participants were recruited as a comparative group into this study and they were also assessed using BDDE, MBSRQ-AS, and RSE-S. A total of 14.2% of 106 aesthetic patients and 1% of 100 healthy controls were diagnosed with BDD to varying extents. BDDE scores were 72.83 (SD±30.7) and 68.18 (SD±31.82), respectively, before and after the procedure for the aesthetic patient group and 43.44 (SD±15.65) for the healthy control group (F=34.28; p<0.001). There was a significant difference between the groups in subscales of MBSRQ-AS, i.e. appearance evaluation (F=31.31; p<0.001), appearance orientation (F=31.65; p<0.001), body areas satisfaction (F=27.40; p<0.001), and RSE-S scores (F=20.81; p<0.001). There was no significant difference, however, in subscales of MBSRQ-AS, i.e. overweight preoccupation (F=1.685; p=0.187), self-classified weight (F=0.908; p=0.404) between groups. All the subscales of MBSRQ-AS showed significant differences between the aesthetic patients (pre-procedure) and female adult norms from Dr. Cash's result given in Table4 (p<0.001). The study also showed that there were no significant differences in the scores of BDDE, MBSRQ-AS, and RSE-S of those fifteen aesthetic patients diagnosed with BDD after aesthetic procedures lasting one month. There was a high prevalence rate (14.2%) of body dysmorphic disorder in aesthetic procedure seekers, and it seemed that those patients suffering from BDD were more likely to be dissatisfied with the results of the aesthetic medical procedures. However, general aesthetic patients showed improvement in most assessments which indicated that aesthetic medical procedures could not only enhance patient appearance, but also patient low self-esteem and QoL. Self-satisfaction could also be promoted. A screening procedure for BDD including suitable screening questionnaires might be considered for routine use in aesthetic clinical settings to minimize dissatisfaction and complaints. This journal requires that the 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 .

Male facial aesthetics: understanding an emerging segment of patients

Men are increasingly seeking medical aesthetic procedures to look younger and compete with the younger generation, says Daniel Sister. Based on his experience of providing facial rejuvenation treatments, he looks at how this group of patients has emerged over time. He also uses a recent male case study to highlight how managing male patients can differ from treating women

Industry figures come together to form the Joint Council for Cosmetic Interventions

Health Education England's expert reference group for the national project surrounding non-surgical cosmetic interventions has been working behind the scenes to create a new council for aesthetic practitioners. In this month's column, Yvonne Senior outlines the six main aims of the newly-formed group and its approach to regulating all providers of medical aesthetic procedures