Search Results (264)

Background/Objectives: Cellulite is a common aesthetic condition in women, traditionally assessed using visual inspection and palpation-based scales that are inherently subjective. Therefore, image-based methods that may support standardized severity grading are of growing interest. To evaluate infrared thermography as an imaging-based method for grading cellulite severity and to perform methodological validation of a newly developed thermographic classification scale by comparing it with clinical palpation and anthropometric parameters. Methods: This retrospective, non-interventional study analyzed anonymized clinical and thermographic data from 81 women with clinically assessed cellulite. Cellulite severity was evaluated using the Nürnberger–Müller palpation scale and a newly developed five-point thermographic scale based on skin surface temperature differentials and histogram pattern analysis. The associations between the assessment methods were evaluated using ordinal statistical measures, and agreement was assessed using weighted Cohen’s kappa statistics. Results: Thermographic grading demonstrated high agreement with palpation-based assessment, with a percentage agreement of 93.8% and an almost perfect agreement based on weighted Cohen’s κ. A strong ordinal association was observed between the methods. Thermography consistently classified a subset of cases as one grade higher compared with palpation. No statistically significant associations were observed between thermographic grade and body mass index or waist-to-hip ratio. Conclusions: Infrared thermography enables image-based grading of cellulite severity and shows a strong concordance with established palpation scales. The proposed thermographic classification provides preliminary methodological validation of an imaging-based grading approach. Further multicenter studies involving multiple assessors and diverse populations are required to assess reproducibility, specificity, and potential clinical applicability. Full article

Background: Hyaluronic acid (HA) injections have become a cornerstone of minimally invasive aesthetic medicine. While the demand for these procedures continues to grow globally, large-scale longitudinal analyses of patient demographics and specific injection site trends remain limited, particularly in Asian populations. Existing data in Japan are largely confined to aggregate procedure numbers. This study aimed to elucidate the transition in patient demographics and site-specific treatment trends using a nationwide big-data approach. Methods: This retrospective study analyzed 299,413 treatment sessions (417,590 injection sites) from patients who underwent facial HA injections at 110 clinics across Japan between October 2020 and December 2024. Data were analyzed by year, patient age, and injection site to evaluate demographic shifts and treatment patterns. Results: The annual number of treatment sessions increased steadily during the study period. A significant demographic shift was observed: while patients in their 20s were predominant in 2020–2022, the proportion of patients aged ≥ 40 years increased markedly from 2023 onward, accounting for more than half of all cases (63.7% in 2024). Treatment preferences varied distinctly by age; younger patients favored localized contouring (e.g., pretarsal fullness, chin), whereas older patients required multi-site rejuvenation. By 2024, the orbital rim became the most frequently treated site (22.6%). Statistical analysis confirmed that age was a significant predictor for multi-site treatments (p < 0.001). Conclusions: This large-scale analysis reveals a clear transition in the Japanese aesthetic market from contour enhancement in younger demographics to anatomy-based rejuvenation in middle-aged and older populations. Full article

Aesthetic Medicine is advanced as an integrated, evidence-based framework for patient-centered care that unites physical, psychological, social, and aesthetic dimensions of health. Drawing on Clinical Health Psychology, the paper introduces Aesthetic Health Psychology as a specialization that embeds psychological theory, assessment, and intervention within aesthetic medicine and surgery, emphasizing interdisciplinary collaboration rather than professional mistrust. The paper argues that integrating Aesthetic Health Psychology into aesthetic medicine can enhance ethical practice, improve patient-reported outcomes, and support equity-focused implementation across diverse procedures and settings. It further suggests a practical framework for implementation. Three interrelated models are proposed: the Aesthetic Biopsychosocial Model, which conceptualizes aesthetics as a distinct health domain alongside biological, psychological, and social factors; the Aesthetic Health Care Process Model, which structures care as a five-stage journey supported by systematic screening for body dysmorphic disorder and the routine use of patient-reported outcome measures; and the Aesthetic Health Systems Model, which situates aesthetic care within institutional, policy, and cultural contexts. Idealized but clinically grounded vignettes from elective cosmetic, reconstructive, and gender-affirming settings illustrate how these models address non-linear trajectories of adaptation, evolving expectations, complications, and stigma. These concepts jointly define both the motivation for Aesthetic Health Psychology and its practical implications, from the use of brief, selective aesthetic screening during primary health care visits to the design of equity-focused implementation strategies across aesthetic procedures and settings. Full article

Background/Objectives: Cleft lip and/or palate are common craniofacial anomalies whose surgical repair is classified as clean-contaminated and may be complicated by surgical site infection or palatal fistula. Despite widespread perioperative antibiotic use, there are no standardized, evidence-based recommendations, and rising antimicrobial resistance underlines the need for rational prescribing. This systematic scoping review aimed to map current evidence on prophylactic antibiotic therapy and related perioperative measures in cleft surgery. Methods: A scoping review was conducted using the Arksey and O’Malley framework and reported in line with PRISMA 2020. PubMed, Mendeley and Google Scholar were searched (January 2015–10 February 2025) for English-language retrospective studies, clinical trials, survey studies and systematic reviews concerning prophylactic antibiotics, bone grafting procedures, mouthwash use or oral microbiota in patients undergoing cleft lip and/or palate surgery. Six reviewers independently screened records; two experienced clinicians extracted data on study characteristics, antimicrobial regimens and infectious or microbiological outcomes. Given heterogeneity and the scoping aim, no formal risk-of-bias assessment or meta-analysis was performed. Results: A total of 40 studies met the inclusion criteria, including 21 original research articles. Considerable variation in antibiotic choice, timing and duration was observed, with no clear superiority of any regimen. Single-dose perioperative prophylaxis appeared non-inferior to prolonged courses in several settings. Oral microbiota studies highlighted colonization by resistant and opportunistic pathogens in cleft patients. Conclusions: Current evidence supports individualized, often short-course perioperative antibiotic strategies rather than routine prolonged therapy. High-quality randomized and microbiological studies are required to develop standardized, resistance-conscious guidelines. Full article

In recent years, there has been rapid growth in aesthetic medicine and an increase in the number of minimally invasive procedures aimed at improving appearance. With the increasing number of procedures performed, the incidence of post-operative complications is also rising, and high-frequency ultrasound (HFUS) is increasingly being used to assess these complications. The article presents the case of a 52-year-old woman who reported for an HFUS examination several months after non-surgical nose correction with hyaluronic acid (HA) and implantation of polydioxanone (PDO) lifting threads. The patient experienced post-treatment complications in the form of erythema, oedema and pain, followed by blanching and bruising of the skin. Hyaluronidase and prednisone were used for treatment. Four months after the procedure, the patient returned for another HFUS examination because, despite the disappearance of most symptoms, uneven purple-blue discoloration of the skin on the nose and a subjective feeling of cold persisted. At the time of the HFUS examination, the discoloration was barely visible. The grey-scale HFUS examination revealed foci corresponding to HA deposits and PDO threads located in close proximity to the dorsal artery of the nose. A Doppler examination revealed blood flow disturbances in this artery, which may indicate compression by the threads and be the likely cause of the patient’s complaints. High-frequency ultrasound has proven to be a useful diagnostic method for assessing such complications. Due to its safety, non-invasiveness and high reliability, HFUS has the potential to become a common diagnostic tool in aesthetic medicine practice. Full article

Hyaluronic acid (HA)-based fillers are widely used in aesthetic dermatology for their biocompatibility, reversibility, and safety; however, adverse events (AEs) may occur. This review evaluated the safety profile, focusing on short- and long-term AEs, of HA fillers manufactured with MACRO (MAtrix CROsslinking) Core Technology, encompassing both current saypha and former Princess products. A systematic PubMed search identified prospective clinical trials assessing safety outcomes following facial aesthetic use of these fillers. Eleven studies including 947 patients met the inclusion criteria. The most common short-term AEs were transient swelling, injection site pain, and bruising, which were predominantly mild to moderate and resolved within two weeks. Severe or serious treatment-related events were rare, with only one reported across all studies. Long-term AEs, such as delayed-onset nodules or inflammatory reactions, were infrequent and mild, with no granulomas, hypersensitivity responses, or vascular complications observed. Safety outcomes were consistent across formulations and between the legacy Princess and current saypha products. Overall, the saypha HA filler portfolio demonstrates a predictable and strong safety profile within the expected range reported in the broader literature, noting the limitations of cross-study comparisons. Most AEs were related to injection trauma rather than the filler itself, supporting its continued use in clinical aesthetic practice. Full article

In this review we present a comprehensive overview of the published literature related to the use of Hybrid Cooperative Complexes (HCCs) of low- and high-molecular-weight hyaluronic acid in aesthetic medicine. HCCs have been developed to overcome the shortcomings of traditional hyaluronic based dermal fillers. Specifically, HCCs deliver both high- and low-molecular-weight hyaluronic acid (HA), maximizing their complementary effects. They are biocompatible and formulated without the addition of foreign agents. Cooperative hydrogen bonds extend their durability and make them more resistant to hyaluronidase compared to high-molecular-weight HA. The rheological properties of HCC formulations allow for easy exertion through the needle and diffusion in the tissue compared to high-molecular-weight HA alone. In vitro studies have shown that HCCs improve vitality of fibroblasts, keratinocytes and adipocytes, and stimulate production of collagen and elastin. Studies on scratched co-cultures of immortalized human keratinocytes and human dermal fibroblasts demonstrated that HCCs accelerate wound closure. Furthermore, HCCs delayed senescence of mesenchymal stromal cells to a greater extent than high-molecular-weight HA or low-molecular-weight HA alone. Clinical studies show a reduction in wrinkle severity, improvement in skin roughness profile and reduction of skin laxity with pronounced improvement in superficial skin hydration lasting up to 6 months. The formulation intended for restoration of fat compartments demonstrated reduction in cheek volume loss and improvement in skin thickness. Subjects report moderate-to-high satisfaction and are likely to recommend the treatment. Limitations of the published studies are also addressed, as well as reported adverse events and published safety data. Full article

The rising number of Hyaluronic acid (HA) filler applications has led to an increase in the incidence of complications, which can range from undesired aesthetic outcomes to severe vascular occlusion events. Hyaluronidase (Hyal) hydrolyzes HA molecules and represents the preferred treatment for managing complications associated with HA fillers. Although Hyal formulations are safe and effective, Hyal use for treating complications of aesthetic procedures remains off-label in many countries due to the lack of standardized protocols and varying recommendations on dosing strategies. Here, we review the use of Hyal in aesthetic medicine, focusing on the available formulations, including galenic preparations, and the associated risks. We provide an update on the current clinical practice for Hyal administration by reviewing cases reported in the literature from 2020 to 2025. We summarize the current dosage strategies and administration techniques for treating different complications, with details on newly developed protocols, the implementation of imaging guidance, and adjunctive treatments. Despite the great variability in dosage and protocols, Hyal administration is a safe and effective treatment to manage complications and undesired aesthetic outcomes caused by HA fillers. Future efforts should focus on developing standardized protocols to facilitate the decision-making process, reduce response time, and ensure successful outcomes. Full article

Background: In recent years, hyaluronic acid filler for the restoration and increase in buttock volume has been a procedure that has seen increasing success, both thanks to the considerable increase in patient demand and thanks to the improvement of implant techniques and device manufacturing technologies. Aims: The primary objective of this pilot study is to demonstrate the validity of an innovative filler inoculation technique in the upper quadrants of the buttocks and in the supra- and subfascial area in order to optically restore the appearance of a pleasant lumbar lordosis and to lift the upper quadrants with reduction in the infragluteal fold. The secondary objective is to evaluate the safety and efficacy of Sofiderm SubSkin^® (Techderm Biological Products Co., Ltd., Hangzhou, China), a highly versatile hyaluronic acid filler, formulated with a rheology suitable for use on the face and body. Patients/Methods: Five female subjects (50–63 years) were subjected to gluteal fillers in the supra- and subfascial areas; the correct positioning of the filler was investigated by means of a 20 Mhz ultrasound probe. Results: All patients obtained a significant improvement in the projection of the upper part of the buttocks. The implantation technique and the optimal rheological properties of the device brought about a natural and well-defined increase in volume, with a projection of the upper part of the buttocks and a consequent lifting of the lower parts and reduction in the length of the infragluteal fold. Conclusions: This study confirmed the efficacy and safety of the cross-linked hyaluronic acid Sofiderm Derm SubSkin^® in increasing the projection of the upper part of the buttocks, using an innovative mixed implantation technique, in a sample of selected patients. Full article

Injectable hydrogels (IHs) have gained considerable interest in biomedical and aesthetic applications due to their minimally invasive delivery, selective localization, and sustained release of bioactive agents. They exhibit flowability during administration and undergo in situ gelation under physiological conditions. These behaviors are influenced by their tunable structural, physical, mechanical, and viscoelastic properties, modulating performance. Rheological parameters, including viscosity (η), storage modulus (G′), loss modulus (G″), and yield stress (τ_y) of IHs with time (t), shear rate ($\stackrel{·}{\gamma }$), and frequency (f), explaining their shear thinning, thixotropy, viscoelasticity, and gelatin kinetics, serve as key quantitative indicators of their injectability, self-healing capability, and structural and mechanical stability. The rheological characteristics reflect molecular interactions and crosslinking mechanisms within IH networks, thereby linking formulation to provide overall performance, including injectability, biodegradability, and controlled release. This review summarizes recent advances in IHs for diverse applications, with a primary focus on their rheological properties. It also briefly addresses their composition, intermolecular interactions, and correlated function and performance. The applications discussed include hemostatic and wound dressings, tissue engineering and regenerative medicine scaffolds, drug delivery systems, reconstructive and aesthetic materials, and functional bioinks for 3D printing. Overall, this review demonstrates that rheological characterization provides an essential framework for the rational engineering of next-generation IH systems. Full article

Background: Facial atrophic acne scars have a significant impact on patients’ psychosocial well-being and remain a therapeutic challenge. Existing treatments options are frequently limited by modest efficacy and adverse effects. The combination of Polynucleotide High-Purification Technology (PN HPT™) and hyaluronic acid (HA) represents a novel bioregenerative strategy aimed at improving dermal remodelling and overall skin quality. Methods: This six-month, prospective, real-world study evaluated the efficacy and safety of Newest^® (Mastelli S.r.l., Sanremo, Italy), a sterile intradermal gel containing highly purified polynucleotides (10 mg/mL) and HA (10 mg/mL). Eligible participants, aged 20–60 years with moderate-to-severe atrophic facial post-acne scars, underwent four treatment sessions in two-week intervals. Efficacy was assessed using the Acne Scar Assessment Scale (ASAS) and Global Aesthetic Improvement Scale (GAIS) at three and six months, while safety was monitored throughout the study. Results: A total of 62 patients (32 Caucasian, 30 Asian; 19 males, 43 females; mean age: 36.6 years) completed the study. At three and six months, 46.8% showed at least a one-grade reduction in ASAS score with respect to the baseline. Patient-reported GAIS indicated that 54.8% perceived an improvement in scar appearance, aligning with investigator assessments. Only one mild, transient adverse event (wheal formation) occurred, which resolved spontaneously without intervention. Conclusions: In this real-world study, treatment with Polynucleotide High-Purification Technology (10 mg/mL) combined with HA (10 mg/mL) was associated with observable improvementin atrophic facial acne scars, with an excellent safety and tolerability profile. These findings support the potential of polynucleotide-based therapies for use as well-tolerated options for managing moderate-to-severe atrophic acne scarring, while the need for further controlled studies to confirm efficacy is also acknowledged. Full article

Background: Recent advancements in regenerative medicine have introduced mesenchymal stem cell–derived exosomes (MSC-Exos) as a novel therapeutic approach. Exosomes are extracellular vesicles containing proteins, lipids, and RNAs capable of modulating cellular behavior and promoting tissue regeneration. A systematic review of human studies is warranted to summarize outcomes, assess therapeutic value, and guide clinical applications. Objectives: This systematic review synthesizes current evidence on mesenchymal stem cell–derived exosomes for cutaneous scars, aging, and hyperpigmentation, with a focus on functional and aesthetic outcomes. Method: A comprehensive search of PubMed, Scopus, Embase, Web of Science, and Google Scholar (January 2010–July 2025) was performed following 2020 PRISMA guidelines. Eligible studies included studies that were randomized controlled trials, pilot studies, case series, and case reports involving human participants treated with MSC-Exos. Outcomes assessed were scar remodeling, pigmentation, skin regeneration, recurrence, and adverse events. Data extraction and bias assessment were conducted independently. Result: Six studies (n = 99; age 19–72 years) from diverse regions, including the United States, the Republic of Korea, and México, were included. MSC-Exos therapy showed promising improvements in reducing scar thickness (32.5% vs. 19.9%, p < 0.01), wrinkle parameters were reduced by 1 (2.4–14.4% vs. 6.6–7.1%, p < 0.05), and elasticity was enhanced (+11.3% vs. −3.3%, p = 0.002) Additional benefits included hydration (+6.5% vs. +4.5%, p = 0.37) and reduced melanin index (−9.9% vs. −1%, p = 0.44). The Global Aesthetic Improvement Scale score showed significant improvement (p = 0.005). Using the Investigator Global Assessment, 16 out of 25 areas treated with exosomes showed significant improvement (grade ≥ 2), compared to 12 out of 25 areas in the control group (p = 0.02), indicating that exosome treatment led to more visible improvement. Complete resolution of icepick scars, partial improvement of boxcar/rolling scars, and no recurrence of keloids (18/21) were reported. Adverse events were mild and transient. Conclusions: Early human evidence suggests that MSC-Exos may offer potential therapeutic benefits for scars, hyperpigmentation, and skin aging, with favorable short-term safety profiles. However, the current evidence remains preliminary due to small sample sizes, heterogeneous study designs, and limited follow-up durations. Larger, well-designed randomized trials are needed to confirm long-term efficacy and safety. Full article

Hyaluronic acid formulations are widely used in aesthetic and regenerative medicine, yet molecular weight-dependent effects on cellular repair remain incompletely characterized. This study investigated two hyaluronic acid formulations—low- and medium-high-molecular-weight ranges with trehalose (LMHMW-HA; 200–400 and 1200–1500 kDa) and high-molecular-weight range (HMW-HA; 1800–2600 kDa)—on keratinocyte repair using an in vitro scratch assay. Human keratinocyte monolayers were treated with various concentrations, and repair dynamics were monitored over 48 h through microscopy and quantitative inter-edge distance analysis. Both formulations significantly enhanced gap closure compared to controls without cytotoxic effects. LMHMW-HA promoted gradual closure over 48 h with increased cellular density, indicating sustained proliferation and migration. HMW-HA induced faster closure at approximately 30 h, accompanied by transient pericellular swelling consistent with hydration-mediated edge approximation. These findings indicate that LMHMW-HA and HMW-HA promote repair through distinct patterns: LMHMW-HA was associated with gradual closure and increased cellular density consistent with proliferation-driven repair, while HMW-HA induced rapid closure with transient pericellular swelling consistent with hydration-mediated effects. These preliminary observations suggest complementary repair mechanisms and provide a foundation for future mechanistic investigations. The molecular weight-tailored approach combining HA with trehalose offers therapeutic potential for aesthetic and regenerative medicine applications requiring enhanced tissue repair. Full article

Background/Objectives: Social media popularity and shifting cultural standards of beauty have intensified the growing demand for cosmetic procedures in Saudi Arabia, and body dysmorphic disorder (BDD) has not previously been given due consideration in cosmetic surgery-seeking behavior. This study determined the proportion of females screening positive for BDD and identified its predictors. Participants and methods: The present study employed an analytical cross-sectional design and was conducted from January 2025 to July 2025 in the Dammam region (Eastern) of Saudi Arabia. A validated tool was utilized to assess sociodemographic characteristics, cosmetic surgery history and intentions, social media exposure, and BDD symptoms. We applied a multivariate analysis to identify the predictors. Results: Among the 250 participants, 72 (28.8%) screened positive for BDD. The positive screening for BDD was significantly higher among the participants with a qualification of university and above (ref: up to high school, AOR = 1.291, 95% CI = 1.016–1.667, p = 0.038), who considered cosmetic surgery during their current visit (ref: no, AOR = 3.123, 95% CI = 1.671–4.982, p = 0.001), and more than 3 h use of social media (ref: less than 1 h, AOR = 4.368, 95% CI = 3.570–5.134, p = 0.007). Conclusions: The present findings suggest that a BDD screening program and a multidisciplinary approach are required to ensure ethical practice and to decrease the repeated or unnecessary interventions. Furthermore, future multicenter and mixed-method studies should be conducted to confirm these findings and guide national psychological assessment practices in aesthetic medicine. Full article

Cellulite, or edematous-fibro-sclerotic panniculopathy (EFSP), is a multifactorial condition affecting most postpubertal women, characterized by surface irregularities with significant psychosocial impact. Its pathogenesis involves adipocyte metabolism, fibrous septa, microvascular dysfunction, extracellular matrix (ECM) remodeling, oxidative stress, and low-grade inflammation. Topical therapies remain among the most accessible approaches, acting on specific biological pathways. Osmotic and vSSasomodulatory formulations reduce edema and improve microcirculation, while methylxanthines such as caffeine and aminophylline promote lipolysis and enhance cutaneous blood flow. Retinoids mainly target the ECM, stimulating neocollagenesis and dermal thickening, with greater efficacy in early EFSP. Botanicals, including Centella asiatica, Rosmarinus officinalis, and Ginkgo biloba, provide antioxidant, anti-inflammatory, and venotonic effects. Randomized controlled trials consistently report modest but reproducible benefits: localized circumference reductions and improved elasticity, echogenicity, and orange-peel scores, all with excellent tolerability. Recent innovations, such as lipid nanoparticles, ultradeformable vesicles, and microneedle-assisted delivery, aim to enhance penetration, stability, and sustained bioactivity of established actives. Nonetheless, most studies are small, short-term, and heterogeneous, with limited ability to isolate the role of individual components or control for massage-related effects. Artificial intelligence offers opportunities to standardize outcome measures, optimize formulations, and personalize protocols. Overall, topical therapies are best positioned as safe, biologically active adjuncts within multimodal cellulite management. Full article