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Background: Facial fold and groove formation is influenced by the ptosis of the superficial fat compartments in the mid-face region., Objective: This study aimed to design a facial rejuvenation technique that targets sagging of the mid-face fat compartments and achieves a youthful facial configuration., Materials and Methods: A total of 102 patients underwent suture net restoration. Each specific ptosis fat compartment was carefully lifted and held at the regional facial ligaments to effectively restore volume distribution. Patient outcomes were evaluated through preoperative and postoperative photography comparison, 3-D photographic analysis, and postoperative evaluations., Results: Significant mid-cheek rejuvenation was observed. The procedure resulted in a remarkable, 10.89% increase in malar projection. The nasolabial fold improved by at least 1 grade in 61.43% of the patients and by at least 2 grades in 37.14%. A total of 87.65% of the patients expressed high satisfaction or satisfaction with the outcomes of the procedure., Conclusion: By specifically targeting the mid-face ptosis fat compartments, the technique demonstrated significant enhancements of both the nasolabial fold and the malar projection. The results indicate that this novel technique holds promise as an efficient approach for satisfactorily addressing facial aging concerns., Competing Interests: All authors declare no actual or potential conflict of interests. No funding was received for this article., (Copyright © 2024 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Background: A previous study using a parallel cooling plate cryolipolysis applicator demonstrated the efficacy of cryolipolysis for pseudogynecomastia. Although the procedure was safe and effective, treatment times were prolonged and anesthetic was needed to reduce treatment discomfort., Objective: To evaluate the safety, efficacy, and tolerability of a short cycle, reduced vacuum contoured cup cryolipolysis applicator for the treatment of pseudogynecomastia., Materials and Methods: Twelve male subjects received simultaneous bilateral treatment consisting of a 35-minute cryolipolysis cycle, followed by a short manual massage, and a second 35-minute cycle with 50% treatment area overlap in a single treatment visit. At the 6-week follow-up, a second treatment was performed with up to 2 overlapping cycles per side. Efficacy was assessed after the second treatment using transcutaneous ultrasound, standardized clinical photography, and subject surveys., Results: Ultrasound analysis showed a mean fat layer reduction of 5.1 ± 2.3 mm (p < .001). Blinded, independent reviewers correctly identified 97% of baseline/treatment photography results. Surveys revealed 100% subject satisfaction with 91% reporting visible fat reduction and 100% stating they would recommend treatment. Transient side effects included mild intratreatment discomfort, paresthesia, and tenderness., Conclusion: A rapid cycling, reduced vacuum cryolipolysis applicator provides rapid, safe, effective, and tolerable treatment of pseudogynecomastia., (Copyright © 2022 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Background: Weight loss is traditionally viewed as straightforward counting of calories in and calories out, with little regard to the role of the adipocytes tasked with storing said calories. However, the body executes a complex compensatory response to any intervention that depletes its energy stores. Here, the authors discuss the methods used to attain weight loss, the body's response to this weight loss, and the difficulties in maintaining weight loss. Furthermore, the authors provide an overview of the literature on the physiological effects of liposuction., Objective: To describe the role of adipose tissue in energy homeostasis, methods of weight loss, weight regain, and the effect of liposuction on endocrine signaling., Methods: The authors conducted a narrative review of representative studies., Conclusion: A variety of strategies for weight loss exist, and optimizing one's weight status may in turn optimize the aesthetic outcomes of liposuction. This is most apparent in the preferential reaccumulation of fat in certain areas after liposuction and the ability to avoid this with a negative energy balance.

Background: During minimally invasive aesthetic procedures, the skin is often pinched to facilitate filler injection or thread insertion into the desired layer. However, little is known about changes in the facial layers during pinch manipulation., Objective: To determine which layer of the temple is lifted during pinching and whether the artery and the nerve are affected by pinching., Materials and Methods: At 11 sites on 3 fresh Korean cadavers, the skin of the temple was pinched gently or deeply, and the skin pulled up was cut at the bottom. The exposed areas were grossly and histologically examined., Results: With gentle pinching, the subcutaneous fat and superficial temporal fascia (STF) layer were separated, and the fat was removed with the skin. The superficial temporal artery and temporal branches of the facial nerve were intact. With deep pinching, the STF was separated from the deep temporal fascia and lifted with the skin., Conclusion: When thread lifting is performed, deep pinching is helpful for anchoring thread to the temporal fascia, whereas gentle pinching helps to insert thread into the safe subcutaneous fat layer, where no significant blood vessels or nerves are present.

Background: There is an increased demand for the reduction of localized adipose tissue by noninvasive methods., Objective: The objective of this study was to determine the safety and efficacy of noninvasive lipolysis of excess adiposities overlying the lateral thigh region using acoustic wave therapy (AWT). This study incorporates 2 mechanical waves with varying properties in the same session: radial and planar AWT., Methods and Materials: The treatment was performed using AWT on the lateral thigh areas of 15 female patients. The study was performed using the planar and radial pulse handpieces, with 8 sessions performed within 4 weeks. Follow-up visits were performed 1, 4, and 12 weeks after the last treatment., Results: Reduction in both thigh circumference and subcutaneous fat layer thickness, measured through ultrasound, was observed., Conclusion: This study demonstrates that AWT is safe and efficacious for the treatment of localized adiposities in the saddlebag area. However, the results obtained were not statistically significant. Larger studies will be needed to further access the effects of AWT on thigh circumference reduction. Furthermore, the authors also found an improvement in the appearance of both cellulite and skin firmness after the treatments.

Background: Anecdotally, there have been reports of skin tightening after cryolipolysis, but this has not been studied or reported in the literature., Objective: This clinical evaluation of patients treated with cryolipolysis in the thighs, abdomen, arms, and back assesses changes to skin texture, laxity, and cellulite at 2 study centers., Methods: From the Vancouver site, a comprehensive review of cryolipolysis treatments was performed to assess treatment areas and retreatments. While reviewing data, investigators were struck by the noticeable skin tightening shown in clinical photographs. Subsequently, a survey of Vancouver patients was conducted to assess changes to skin texture and laxity. At the Marina del Rey site, subjects undergoing a clinical study for lateral thigh cryolipolysis were evaluated for changes to skin texture, laxity, and cellulite., Results: Independent assessments by patients and investigators found consistent improvement in skin texture and laxity for treatments to the outer thighs, abdomen, arms, and back. Outer thighs also showed mild-to-moderate improvement in cellulite., Conclusion: This clinical evaluation demonstrates consistent improvement in skin texture, laxity, and cellulite after cryolipolysis as independently assessed by patients and investigators. Prospective clinical studies should be conducted to objectively study and quantify skin tightening after cryolipolysis.

Background: Previous clinical studies have investigated cryolipolysis for noninvasive reduction of fat in abdomens, outer thighs, flanks, and backs. This study investigated feasibility of cryolipolysis for inner thigh treatment., Objective: This pilot study evaluated a cryolipolysis flat cup vacuum applicator for treatment of inner thigh fat., Methods: A prototype vacuum applicator was used to treat n = 11 subjects in a single-side inner thigh study. Cryolipolysis treatment was delivered to the larger thigh while the contralateral thigh served as a control. Follow-ups were conducted at 8 and 16 weeks. Equalization treatments were subsequently delivered to the contralateral thigh. Safety was assessed by monitoring side effects and adverse events. Efficacy was evaluated by ultrasound imaging, clinical photography, and patient surveys., Results: Side effects were typical and resolved spontaneously. Efficacy was demonstrated with ultrasound measurements showing 83% of subjects attained some level of fat layer reduction. Normalized mean reduction in fat layer thickness was 20%, corresponding to 3.3 mm. Patient surveys revealed 91% were satisfied and 82% felt inner thigh cryolipolysis was comfortable. Clinical photographs revealed visible reduction in inner thigh contour after treatment., Conclusion: This study demonstrates feasibility of safe and efficacious cryolipolysis treatment to the inner thigh.

Background: Ultrasound lipoclasia (USL) on white adipose tissue (WAT) has been largely used in the treatment of cellulite. Nevertheless, the acute consequences of this therapy on metabolism and biochemical profile are significant and should be taken into account., Objectives: To analyze the acute metabolic effects of USL in WAT of healthy rats using analyses of body composition, biochemical profile, and inflammatory markers., Methods: Female Wistar rats weighing approximately 250 g were divided into two groups (n=10 each): control and treated. The treated group was submitted to USL, a single 3-MHz ultrasound application (5.6 W/cm(2)), in gluteal-femoral WAT (3 cm(2)) for 3 minutes. Animals were subjected to glycemic control. Body composition was analyzed using bio-impedance, and lipid profile, insulinemia, C-reactive protein (CRP), and lactate dehydrogenase (LDH) were measured., Results: USL reduced (p<.05) body fat mass. The basal metabolic rate was found to have increased (p<.05). Basal insulin and the lipoprotein profile were not different, although the glycemic curve and CRP and LDH (p<.05) levels were higher., Conclusions: Fat mobilization using USL provokes acute hyperglycemia and enhances an acute inflammatory response, producing cardiometabolic risk in female rats.