BACKGROUND:Facelift surgery is a cornerstone of facial rejuvenation, yet it may not fully address volume loss, skin quality, or other age-related changes. Minimally invasive procedures-such as injectables and energy-based devices-are increasingly utilized before and after facelift surgery, though their impact on surgical outcomes remains uncertain. OBJECTIVE:The objective of this single-center retrospective pilot study is to describe patterns of minimally invasive procedures among patients undergoing facelift surgery in a real-world clinical setting and identify areas for future investigations regarding their potential influence on surgical outcomes. METHODS:We analyzed data from 20 patients who underwent facelift surgery and had a documented history of neurotoxin, filler, biostimulator, or energy-based device treatment. Data included patient demographics, treatment history, surgical details, and post-operative satisfaction. Given the limited sample size and retrospective design, the analyses done were descriptive and exploratory in nature. RESULTS:All patients received neurotoxin prior to facelift, 90% received hyaluronic-acid filler, and 55% received poly-L-lactic acid or calcium hydroxylapatite. Following surgery, all patients resumed neurotoxin use, and 60% received filler treatments within the first post-operative year. No reported significant surgical complications occurred because of prior filler or biostimulator treatments, and patient satisfaction was high for facelift outcomes. CONCLUSION:Within our small, retrospective cohort, prior injectable or energy-based device use was not associated with an increased risk of observable adverse surgical outcomes; however, the limited sample size precludes definitive assessment of safety or risk. Larger, prospectively designed studies are warranted to validate these early observations and optimally define best practices for combining surgical and nonsurgical rejuvenation.
BACKGROUND:Glucagon-like peptide-1 (GLP-1) receptor agonists have been associated with cutaneous changes including accelerated skin aging and volume loss. The biological mechanisms underlying these effects remain poorly understood, with limited in vivo human data. OBJECTIVE:The aim of this study was to evaluate adipogenesis-associated cellular markers in subcutaneous adipose tissue of patients receiving GLP-1 receptor agonist therapy. METHODS:Abdominal adipose tissue biopsies from patients receiving GLP-1 receptor agonists and untreated controls were analyzed using multiplex immunofluorescence to quantify FSP1, CD90, CD105, CD73, and ERG and to characterize adipose-derived stem cells (ADSCs) and fibroblast populations. RESULTS:Baseline analysis of 10 adipose tissue samples demonstrated a statistically significant reduction in adipose-derived stem-cell counts in the GLP-1 group compared with controls (11.0 vs 44.8 cells/mm2, p = .039), representing an approximately four-fold decrease. CD90+ cell counts were also significantly lower in the GLP-1 group (p = .047). Fibroblast populations were not significantly different between groups, suggesting selective depletion of the stem-cell compartment. CONCLUSION:This is the first in vivo human study demonstrating a significant reduction in the ADSC population in patients on GLP-1 receptor agonist therapy. Selective depletion of ADSCs offers a potential mechanism for the accelerated skin aging changes in this population beyond weight loss alone.
ABSTRACT Background Hyaluronic acid (HA) dermal fillers are widely used to correct age‐related midface volume deficits and improve self‐perceived attractiveness. TEOSYAL RHA 4 (also FDA‐approved as RHA Dynamic Volume) (RHA4) is a high‐strength, moderate‐stretch HA volumizing injectable designed to maintain facial dynamics. Objectives To evaluate the effectiveness and safety of RHA4 versus an active comparator (Juvéderm Voluma XC) for correction of midface volume deficits (MVD). Methods In this controlled, randomized (3:1), blinded live‐evaluator, multicenter prospective clinical study, the primary outcome was the change from baseline in Teoxane Midface Volume Deficit Scale (TMVDS) score, while the co‐primary endpoint was the proportion of responders with ≥ 1‐grade improvement on the TMVDS at 8 weeks post‐treatment. Results Overall, 201 subjects were enrolled (152 RHA4; 49 comparator); 74.6% received multilayer injections in deep and superficial midface fat pads. Mean TMVDS change at 8 weeks was −1.3 ± 0.8 with RHA4 and −1.3 ± 0.6 with comparator ( p = 0.377; upper 95% CI bound < 0.5, non‐inferiority demonstrated). The proportion of subjects achieving ≥ 1‐grade improvement (responder rate) was 87.0% (RHA4) and 90.5% (comparator) ( p = 0.786); the co‐primary endpoint was met (comparator responder rate > 70%). TMVDS responder rate following RHA4 treatment remained above 65.6% for 52 weeks, while subject‐assessed aesthetic improvement and satisfaction remained above 81.3% and 82.8%, respectively. RHA4 exhibited a good safety profile similar to the comparator. Conclusions RHA4 was shown to be as effective as the active comparator for correction of MVD, providing sustained aesthetic outcomes, high satisfaction, and good tolerability.
BACKGROUND:The field of regenerative aesthetics is advancing rapidly, shifting from traditional cosmetic techniques to therapies targeting the biological mechanisms behind tissue degeneration. OBJECTIVE:The authors aimed to explore emerging therapies within the 3 pillars of regenerative aesthetics, cellular treatments, biochemical cues, and scaffolds highlighting recent advancements, regulatory challenges, and opportunities for further research. METHODS:A literature review was performed to identify clinical evidence for regenerative modalities in aesthetic practice, with 74 articles included for evaluation. RESULTS:The review covers adipocyte- and umbilical cord-derived stem cells and stromal vascular fraction (SVF) in aesthetic treatments. Nanofat, created through mechanical emulsification, shows promise by providing higher SVF yields while circumventing stricter regulations on enzymatic methods. Exosomes demonstrate therapeutic potential in wound healing, pigmentation disorders, and skin rejuvenation. Polydeoxyribonucleotides and polynucleotides exhibit significant tissue repair and anti-inflammatory effects; polynucleotides also serve as scaffolds for tissue volumization. In addition, new data suggest that poly- l -lactic acid promotes volumizing effects by increasing adipose-derived stem cells and remodeling the extracellular matrix. CONCLUSION:Further research and regulatory standardization are needed. Future directions may involve integrating regenerative aesthetics with longevity medicine to enhance both rejuvenation and sustained tissue function over time.
