ABSTRACT Background Stem cell‐based therapies are rapidly reshaping dermatology, driven by advances in regenerative medicine, tissue engineering, and molecular therapeutics. The skin, with its intrinsic regenerative capacity and well‐defined stem cell niches, represents a uniquely accessible model for translational application. Objectives To provide a critical overview of stem cell biology in dermatology, evaluate current and emerging clinical applications, and examine the key translational, regulatory, and safety challenges shaping the field. Methods A narrative review of the literature was conducted, incorporating recent clinical trials, systematic reviews, translational studies, and seminal mechanistic reports, with a targeted update through April 2026 to capture major subsequent clinical and regulatory developments. Results Cutaneous stem cells‐including epidermal, hair follicle, melanocyte, and mesenchymal stromal cells‐play central roles in tissue homeostasis, repair, and immune regulation. A paradigm shift has emerged from traditional cell‐replacement strategies toward microenvironmental modulation, with therapeutic effects now understood to be largely mediated by paracrine signalling and extracellular vesicle‐driven mechanisms. Clinical applications have been explored across inflammatory, autoimmune, pigmentary, and wound‐related disorders, as well as in aesthetic dermatology. Among these, gene‐corrected epidermal stem cell transplantation in epidermolysis bullosa represents a landmark example of successful clinical translation with durable outcomes. In contrast, most other indications remain investigational, limited by heterogeneity in study design, variability in cell processing, and insufficient long‐term safety data. Conclusions While stem cell–based therapies hold substantial promise, their integration into routine dermatological practice remains constrained by biological, technical, and regulatory challenges. Emerging approaches‐including extracellular vesicle‐based therapies, gene editing, induced pluripotent stem cell platforms, and precision regenerative strategies‐are poised to define the next phase of the field. Robust clinical validation, standardization of protocols, and stringent regulatory oversight will be essential to translate this promise into safe, effective, and scalable therapies.
ABSTRACT Background The rising demand for non‐invasive cosmetic procedures has led to increased use of biocompatible dermal fillers like Poly‐ l ‐Lactic Acid (PLLA), a synthetic, biodegradable polymer known for stimulating neocollagenesis and providing gradual, sustained volumization. Aim To comprehensively examine PLLA's development, properties, clinical efficacy, safety, and potential future directions in dermatological and aesthetic applications. Methods A systematic review and comparative clinical evaluation were conducted on PLLA's stereochemical structure, biostimulatory mechanisms, and outcomes. Comparisons with hyaluronic acid and calcium hydroxylapatite (CaHA) fillers were included. Results Studies revealed a 30% increase in collagen types I and III within 3 months post‐treatment. Around 80% of patients reported improved skin texture and volume. Mild adverse events (swelling, bruising) were reported in 35% of cases, while serious complications remained rare (0.4%). Advanced techniques—such as cannula use and microjet injection—have reduced complications, with nodule formation rates < 0.5% when proper protocols are followed. Compared to hyaluronic acid and calcium hydroxylapatite, PLLA provides superior long‐term aesthetic outcomes with minimal adverse effects. Conclusion PLLA offers a promising, long‐term alternative for skin rejuvenation. Continued innovation in formulation and delivery systems is expected to expand its dermatologic applications.
ABSTRACT Background The lower face and neck are essential to overall facial harmony and a balanced appearance. Although most nonsurgical treatments have focused on the upper and midface, a variety of minimally invasive options are now available for treating the lower face and neck that target different aesthetic concerns and provide welcome alternatives to surgery. This review offers guidance for clinicians treating the lower face and neck, including a description of the interactions among different facial layers and their contributions to esthetic concerns. Methods The PubMed database was searched for original studies and review articles related to anatomical tissue layers of the lower face and neck and minimally invasive treatments for lower face and neck aesthetic, preferentially considering randomized controlled trials. We synthesized the literature into this narrative review. Results Patient assessment should encompass the entire face and neck, even when aesthetic concerns relate primarily to a single area, and should involve physical examination and photos at rest and during animation. Due to interactions among facial layers, an important goal of assessment is to determine the contribution of bone, fat, muscle, glands, and skin to patients' aesthetic concerns. Minimally invasive treatments for the lower face and neck considered here include fillers, neuromodulators, adipocytolysis, and energy‐based devices. Conclusions Minimally invasive treatments can lead to notable improvement in individual aesthetic concerns of the lower face and neck that serve to highlight their importance in overall appearance. This paper recommends careful patient selection and management of expectations, along with suggestions for combining and sequencing various minimally invasive treatments.
ABSTRACT Background Deoxycholic acid (DCA) injection is an established minimally invasive treatment for localized submental fat (SMF) reduction. Although clinical trials and systematic reviews support its efficacy, submental fullness is anatomically heterogeneous and may not always represent targetable fat. Aims This narrative review summarizes evidence on DCA injection, emphasizing anatomy‐based patient selection and safety planning for submental treatment and cautious off‐label use. Methods This structured narrative review was guided by the Scale for the Assessment of Narrative Review Articles. PubMed/MEDLINE was searched in August 2026 for evidence on DCA efficacy, mechanism, anatomy, imaging, injection technique, safety, and non‐submental applications. Relevant reference lists were also examined. The literature was organized by mechanism, clinical evidence, anatomy, imaging, patient selection, off‐label applications, and safety. Results DCA produces adipocyte membrane disruption followed by inflammatory clearance and tissue remodeling. The strongest evidence supports SMF reduction in patients with localized superficial subcutaneous fat, particularly preplatysmal fat. Similar fullness may result from deep fat, laxity, platysmal banding, glandular or muscular prominence, soft‐tissue ptosis, skeletal deficiency, or regional atrophy; these contributors require different strategies. High‐frequency ultrasound may assist when clinical examination does not clearly identify the dominant contributor or intended tissue plane, but it is an adjunct rather than a stand‐alone test of candidacy or safety. Evidence for non‐submental applications remains limited. Conclusions DCA should be regarded as an anatomy‐dependent adipocytolytic procedure rather than a general “fat‐dissolving” injection. Careful selection, precise placement, and realistic counseling may improve outcomes, reduce avoidable complications, and support cautious, individualized off‐label use.
ABSTRACT Facial rejuvenation has progressively shifted from volumetric correction toward biologically driven regenerative therapies. Autologous fat grafting has gained prominence due to its ability to restore both volume and tissue quality. Among its various forms, nano fat grafting has emerged as a purely regenerative technique, characterized by a high concentration of stromal vascular fraction and adipose‐derived stem cells with minimal viable adipocytes. This article review discusses the biological basis, preparation techniques, clinical indications, and outcomes of nano fat grafting in facial rejuvenation. A comparison has been done between nano Fat grafting and injectable, hyaluronic, skin, boosters, and also emphasis has been taken on the importance of optimal donor [1–4].
