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The extended deep plane facelift is a powerful technique to correct aging of the midface and neck. After many years of superficial muscular aponeurotic system lift techniques, the senior author transitioned to an extended deep plane facelift for all patients. The primary catalyst for this shift in practice was the pursuit of superior rejuvenation of the midface. Consistent uniform elevation of the deep plane with complete ligament release and management of the soft tissue flap were the most significant challenges in the early adoption period. Navigating the transition was facilitated by consultation with experienced colleagues and frequent cadaver dissections. This manuscript details the authors' current technique. Complications and recovery from this technique are similar to those reported with historical techniques and are minimized with proper preparation, precision, and perioperative management. In our experience the results from this procedure are extremely reproducible, durable, and natural, and patients are overwhelmingly extremely satisfied. [ABSTRACT FROM AUTHOR]

Platelet-rich plasma has been increasingly used for facial rejuvenation in conjunction with other modalities such as microneedling or on its own. Nanofat grafting to the face has also been utilized for skin quality improvements. Our group previously described the novel combined Platelet Hybridized Adipose Transplant (PHAT) technique for hair restoration. In this series, we describe our experience with the PHAT technique for lip and facial rejuvenation to improve the quality of facial skin and superficial musculoaponeurotic system, and enhancing surgical results. [ABSTRACT FROM AUTHOR]

Backgrounds and aims: Submental skin laxity (SSL), manifesting as sagging skin and double chin, can significantly affect patients' self-perception and social interactions. While surgical treatments exist, non-invasive methods are increasingly sought for their minimal recovery time. This study assesses the safety and effectiveness of a novel microwave-based device for treating SSL, aiming to provide long-term improvements in skin tightness and appearance. Materials and methods: Ten female patients with moderate to severe SSL underwent two treatments spaced 30 days apart using a 2.45 GHz non-invasive microwave device, with a specific handpiece. Treatment sessions lasted 10 min each, targeting the submental region. The Submental Skin Laxity Grade (SMSLG) was assessed before treatment and 12 weeks after the final session. Safety was monitored, and standardized photographs were taken for clinical evaluation. Results: All patients showed a significant reduction in SSL, with SMSLG scores improving from a mean of 3.6 at baseline to 2.3 after 12 weeks. No adverse effects were reported, and patients experienced minimal discomfort during and after the treatment sessions. Photographs revealed visible improvements in skin tone and tightness across all cases. Conclusions: The microwave-based treatment demonstrated significant efficacy in reducing SSL and improving skin tone with minimal side effects, offering a promising alternative to surgical interventions. This non-invasive approach provides effective outcomes in fewer sessions and may represent a new standard for non-surgical skin tightening in aesthetic dermatology. [ABSTRACT FROM AUTHOR]

Background: Facial aging is a complex process influenced by environmental factors, genetics, and lifestyle. The contribution of the skin microbiota to this process remains poorly understood. Methods: This two-sample Mendelian randomization (MR) study was performed using genome-wide genotype data from the UK Biobank and previously published studies on skin microbiota. The primary approach for MR analyses included inverse-variance weighting (IVW), MR-Egger regression, simple mode, weighted median, and weighted mode methods. Sensitivity analyses were performed to assess heterogeneity and pleiotropy, and reverse-direction MR analyses were performed to evaluate potential reverse causation. Results: The MR analysis identified ten skin microbiotas with potential causal relationships with facial aging. Protective skin microbiotas included Genus Finegoldia, ASV011 [Staphylococcus (unc.)], ASV008 [Staphylococcus (unc.)], phylum Firmicutes, Family Rhodobacteraceae, and ASV021 [Micrococcus (unc.)], which were negatively associated with facial aging. Conversely, Order Pseudomonadales, Family Moraxellaceae, ASV039 [Acinetobacter (unc.)], and phylum Bacteroidetes were positively associated with facial aging, indicating a risk factor for accelerated aging. Sensitivity analyses confirmed the robustness of these findings, and reverse-direction MR analyses did not suggest any reverse causation. Conclusion: This study identified specific skin microbial that may influence facial aging and offered new insights into the rejuvenation strategies. No Level Assigned: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. 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. [ABSTRACT FROM AUTHOR]

Background: Recent progress in anatomy enables a more sophisticated approach to treat patients with facial aesthetic concerns (PFAC) with HA fillers. Furthermore, advances in rheology have offered a range of HA fillers with different biomechanical properties adapted to different indications. Methods: Based on recent anatomical and rheological progresses, the author has developed a new methodology that couples an accurate patient assessment tool and a panfacial precise treatment instrument. In the presented method, the face is divided into 6 units called New Aesthetic Units (NAU). NAUs are classified on the extent of volume deficiency and asymmetry, ranging from none to moderate to severe deficiencies. After discussion with the patient regarding the assessment findings, a customized treatment plan, including timelines and number of sessions, is recommended. The modalities of the treatment are exhaustively described for each NAU based on multilayering, best practice medicine, and expert consensus available in the literature. Results: Before-and after-case studies are presented to illustrate how the NAU method is used in routine practice for the treatment of two patients with HA fillers. Conclusion: The NAU method is not only a practical and accurate roadmap for the assessment and treatment of PFAC with HA fillers, but also facilitates communication between injectors and patients and data analysis. Level of Evidence IV: This journal requires that 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 http://www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Abstract Background Increasing evidence suggests a potential causal association between lipid levels and facial aging. The aim of this study was to investigate the relationship between levels of specific lipids and facial aging via Mendelian randomization methods. Additionally, this study aimed to identify mediators and explore relevant genes and drug targets. Methods In this study, genome-wide association data on plasma lipids from 7,174 Finnish individuals in the UK Biobank were used. Two-sample Mendelian randomization was applied to assess the causal effects of specific lipids on facial aging. Sensitivity and pleiotropy analyses were conducted to ensure the robustness and reliability of the results. Multivariate Mendelian randomization was conducted to account for the potential impact of confounding factors. Furthermore, summary-data-based Mendelian randomization was used to identify relevant genes, which were validated through multiomics data. Finally, drug‒gene interactions were explored via molecular docking techniques. Results Two-sample Mendelian randomization analysis revealed a causal relationship between lipid levels and facial aging. According to the multivariate Mendelian randomization results, smoking was found to mediate this association, and these lipids remained significantly associated with facial aging, even after accounting for environmental confounders. Using summary-data-based Mendelian randomization, CYP21A2, CCND1, PSMA4, and MED1 were identified as potential gene targets, with MED1 further validated through pQTL and mQTL data. Additionally, the MED1 protein was found to bind spontaneously with astragalin, fenofibrate, and ginsenoside. Conclusions The results revealed a causal relationship between lipid levels and facial aging, revealing key gene targets that were still significantly associated with facial aging after controlling for environmental confounders. Additionally, the interactions between MED1 and certain drugs may indicate potential pathways for therapeutic interventions related to facial aging.

Background: The use of non-ablative fractionated lasers for skin rejuvenation has been proven to be effective in improving skin texture, and has become popular due to minimal wounding, significantly shorter recovery times and decreased adverse effects. Objective: To retrospectively analyze improvement in skin texture in healthy women aged over 18 years with Fitzpatrick skin type II-IV. Methods: Participants received 3 facial and/or neck treatments with the 1570-nm fractional scanning diode laser at one-month intervals. Three months after the last treatment session two blinded evaluators assessed skin improvement using before and after photos. Pain and patient satisfaction were recorded. Results: Sixteen women with a mean age of 45.4 ± 4.1 years (range 35–50 years) and skin type II-IV were included in the analysis. All 16 participants received facial treatments and seven (43.8%) also received neck treatments. Three months follow-up evaluation showed that the majority of participants had at least a visible change in the treated areas. Mean pain score was low and decreased with each treatment session. Conclusion: Skin treatment using fractional scanning 1570-nm diode laser improves skin laxity in women with skin types II-IV. Larger studies are warranted to further clarify the efficacy and safety of this modality. [ABSTRACT FROM AUTHOR]

L'auteur s'est intéressé à la volumétrie faciale dès les années 1990, période où il prenait en charge la féminisation du squelette facial afin d'améliorer l'intégration sociale des patients transgenres masculins. Il s'agissait à cette période d'une chirurgie squelettique. Très rapidement, ses techniques ont été étendues aux femmes génétiques souhaitant un visage plus féminin. L'étude du vieillissement facial a permis à l'auteur de définir des critères de vieillissements frontotemporal, en particulier une évolution avec l'âge vers une masculinisation frontotemporale. La correction volumétrique frontotemporale est ainsi devenue un élément important du rajeunissement du visage. L'évolution s'est ensuite naturellement faite vers le concept de beauté frontotemporal. The author became interested in facial volume in the 1990s, during the period when he oversaw the feminization of the facial skeleton to improve the social integration of male transsexual patients. At that time, it was skeletal surgery. Very quickly, these techniques were extended to genetic women who wanted a more feminine face. The study of facial aging allowed the author to define criteria for frontotemporal aging, particularly an evolution with age towards a frontotemporal masculinization. The volumetric frontotemporal correction has thus become an essential element of facial rejuvenation. The evolution then, naturally took place towards the concept of frontotemporal beauty. [ABSTRACT FROM AUTHOR]

Background: Increasing evidence suggests a potential causal association between lipid levels and facial aging. The aim of this study was to investigate the relationship between levels of specific lipids and facial aging via Mendelian randomization methods. Additionally, this study aimed to identify mediators and explore relevant genes and drug targets. Methods: In this study, genome-wide association data on plasma lipids from 7,174 Finnish individuals in the UK Biobank were used. Two-sample Mendelian randomization was applied to assess the causal effects of specific lipids on facial aging. Sensitivity and pleiotropy analyses were conducted to ensure the robustness and reliability of the results. Multivariate Mendelian randomization was conducted to account for the potential impact of confounding factors. Furthermore, summary-data-based Mendelian randomization was used to identify relevant genes, which were validated through multiomics data. Finally, drug‒gene interactions were explored via molecular docking techniques. Results: Two-sample Mendelian randomization analysis revealed a causal relationship between lipid levels and facial aging. According to the multivariate Mendelian randomization results, smoking was found to mediate this association, and these lipids remained significantly associated with facial aging, even after accounting for environmental confounders. Using summary-data-based Mendelian randomization, CYP21A2, CCND1, PSMA4, and MED1 were identified as potential gene targets, with MED1 further validated through pQTL and mQTL data. Additionally, the MED1 protein was found to bind spontaneously with astragalin, fenofibrate, and ginsenoside. Conclusions: The results revealed a causal relationship between lipid levels and facial aging, revealing key gene targets that were still significantly associated with facial aging after controlling for environmental confounders. Additionally, the interactions between MED1 and certain drugs may indicate potential pathways for therapeutic interventions related to facial aging. [ABSTRACT FROM AUTHOR]

Background: Surgical, minimally-invasive, and non-invasive aesthetic procedures try to ameliorate the signs of facial aging, but also focus on enhancing various individual features of beauty in each patient. Herein, the midface plays a central role due to its location but also its importance for the aesthetic perception and facial expression. Objective: To date, no study has investigated the interplay between facial muscles and its connecting subdermal architecture during facial aging to provide a more comprehensive understanding of the middle face. Materials and Methods: A total of 76 subjects, consisting of 30 males (39.5%) and 46 females (60.5%) with a mean age of 42.2 (18.7) years [range 19–80] and a mean BMI of 24.6 (3.7) kg/m2 [range 18–35], were enrolled in this investigation. Cutometry (skin aging), 3D skin displacement analyses (subdermal connective tissue aging), and sEMG (muscle aging) analyses were utilized. Results: The results revealed that overall skin firmness increased, and skin elasticity decreased (p < 0.001), sEMG signal of the investigated muscles decreased (p < 0.001), whereas midfacial mobility remained unaltered (p = 0.722). Conclusion: The results of this study indicate that midfacial aging is a measurable effect when utilizing individual measurement modalities for assessing skin, subdermal fascia, and midfacial muscles. The function of midfacial muscles revealed a potential threshold effect, which is not reached during midfacial aging due to the unchanged soft tissue mobility at older age. However, to understand its clinical presentation all midfacial soft tissues need to be factored in and a holistic picture needs to be created. No Level Assigned: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes review articles, book reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. 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. [ABSTRACT FROM AUTHOR]

[ABSTRACT FROM AUTHOR]

Objective: This review explores the utilization of thread lifting materials, distinct from traditional sutures, in aesthetic procedures. It aims to elucidate the varied composition, purpose, and performance of these slender materials. Methods: The article contextualizes thread lifting materials by exploring their literal and material significance. The evolution of these materials is traced, emphasizing the preexistence of cog threads for tissue manipulation before their widespread adoption in plastic surgery. Results: Observations regarding the efficacy and longevity of absorbable versus non‐absorbable threads are discussed, with a particular emphasis on the efficiency of high‐quality absorbable cog threads. Conclusion: The proliferation of thread lifting materials extends beyond PDO, necessitating consideration of multiple factors beyond duration when selecting threads for lifting procedures. This underscores the importance of comprehensive evaluation in choosing appropriate thread lifting materials. [ABSTRACT FROM AUTHOR]

Background: Facial aging (FA) is a complex process influenced by both genetic and environmental factors. Gut microbiota (GM), gut microbiota metabolic pathways (GMMPs), and blood metabolites (BMs) have been implicated in the regulation of FA, but the causal and mediating effects of these factors remain unclear. Methods: We used summary‐level data from genome‐wide association studies (GWAS) of 16S rRNA gene sequencing data for GM (n = 18 340), GWAS of GMMPs (n = 7738), BMs (n = 24 925), and GWAS of FA (n = 423 999). We applied Mendelian randomization (MR) methods to estimate the causal effects of GM, GMMPs, and BMs on FA. We performed mediation analysis to quantify the proportion of the effects mediated by blood metabolites. Results: We identified nine genus, two phylum, two families of GM, nine GM metabolic pathways, and 73 BMs that showed potential causal effects on FA. After Bonferroni correction, three BMs remained causally associated with FA, including average number of methylene groups per double bond (β, ‐0.023; 95% CI, ‐0.032∼‐0.014; p = 3.120×10‐7) and average number of methylene groups in a fatty acid chain (β, ‐0.031; 95% CI, ‐0.045∼‐0.016; p = 2.062×10‐5), which had strong negative causal effects on FA, and ratio of bisallylic groups to total fatty acids (β, 0.023; 95% CI, 0.017∼‐0.029; p = 8.441×10‐15), which had a strong positive causal effect on FA. Mediation analysis revealed that histidine, average number of methylene groups in a fatty acid chain, and triglycerides in chylomicrons and largest VLDL particles mediated the effects of anaerofilum and/ or superpathway of Laspartate and Lasparagine biosynthesis on FA. Conclusion: Our study provides novel insights into the causal and mediating effects of GM, GMMPs, and BMs on FA. These findings may have implications for the development of new strategies for preventing or delaying FA. [ABSTRACT FROM AUTHOR]

Background and Objectives: Observational research findings have demonstrated correlations between diet and the process of aging. Nevertheless, there remains uncertainty regarding possible disruption caused by confounding variables. To elucidate the connections between diet and aging, we employed the Mendelian randomization analysis. Methods and Study Design: The exposure factor was the daily diet, whereas accelerated aging was measured through telomere length, facial aging (FA), frailty index (FI), and senescence-associated secretory phenotypes (SASPs), representing the outcome factors. The primary analysis employed IVW analysis, with additional MR-Egger and Weighted Median analyses conducted to assess the reliability of the findings. Furthermore, we analyzed the heterogeneity and pleiotropy of the results. Results: The results revealed that the consumption of salad/raw vegetables and oily fish exhibited a negative correlation with FA, whereas coffee intake showed a positive correlation with FA. On the other hand, the intake of cheese, oily fish, dried fruit, and cereal showed negative associations with FI. Additionally, coffee, alcohol, and pork intake were positively associated with FI. Lastly, the intake of bread exhibited a positively correlated with SASPs, while the intake of cheese and coffee showed a negative correlation with SASPs. Conclusions: Our study revealed that the consumption of cheese, vegetables, oily fish, dried fruit, bread, coffee, and alcohol was associated with the aging process. Interestingly, our findings suggest that coffee intake may accelerate aging, whereas intake of oily fish may delay the aging process. However, it is important to note that further well-designed prospective studies are required to validate our findings in the future. [ABSTRACT FROM AUTHOR]

Addressing the intricacies of facial aging in forensic facial recognition, traditional sketch portraits often fall short in precision. This study introduces a pioneering system that seamlessly integrates a de-aging module and a sketch generator module to overcome the limitations inherent in existing methodologies. The deaging module utilizes a deepfake-based neural network to rejuvenate facial features, while the sketch generator module leverages a pix2pix-based Generative Adversarial Network (GAN) for the generation of lifelike sketches. Comprehensive evaluations on the CUHK and AR datasets underscore the system's superior efficiency. Significantly, comprehensive testing reveals marked enhancements in realism during the training process, demonstrated by notable reductions in Frechet Inception Distance (FID) scores (41.7 for CUHK, 60.2 for AR), augmented Structural Similarity Index (SSIM) values (0.789 for CUHK, 0.692 for AR), and improved Peak Signal-to-Noise Ratio (PSNR) metrics (20.26 for CUHK, 19.42 for AR). These findings underscore substantial advancements in the accuracy and reliability of facial recognition applications. Importantly, the system, proficient in handling diverse facial characteristics across gender, race, and culture, produces both composite and hand-drawn sketches, surpassing the capabilities of current state-of-the-art methods. This research emphasizes the transformative potential arising from the integration of de-aging networks with sketch generation, particularly for ageinvariant forensic applications, and highlights the ongoing necessity for innovative developments in de-aging technology with broader societal and technological implications. [ABSTRACT FROM AUTHOR]

Introduction: Facial fillers and injectables have transformed the landscape of cosmetic procedures, offering rejuvenation possibilities. However, the emergence of "Facial Overfilled Syndrome (FOS)" presents a concerning trend attributed to excessive filler use and suboptimal injection techniques. Understanding the interplay between facial aging and augmentation techniques is crucial in addressing and preventing FOS. Material and Methods: Facial overfilled syndrome is characterized by the excessive use of fillers, resulting in a distorted and heavy appearance. It manifests in various forms, including 'flowerhorn' foreheads, 'sunset' eyes, 'chipmunk' cheeks, 'witch' chins, and 'pillow' faces. The syndrome arises from attempts to combat anatomical aging with dramatic filler treatments, causing rapid volume changes and skin tightening. Skeletal structures and soft tissue distribution across different ethnicities play a significant role in FOS development. Results: Understanding the aging process across facial tissues is essential, as fillers cannot entirely reverse aging manifestations. Tailored assessment and treatment plans should precede filler injections, involving muscle assessment, observation of facial movements during injection, and ultrasound imaging of fat layers. Attention should be given to filler pressure and migration risks, particularly in areas with elevated pressure. Additionally, alternative approaches like energy‐based devices and polymer reinforcement of facial ligaments should be considered to minimize filler use. Ethnic variations in facial anatomy require careful consideration to avoid overcorrection. Conclusion: FOS predominantly affects individuals of East Asian descent due to specific facial characteristics. Prevention strategies involve minimizing filler use, addressing underlying bone changes, and considering ethnic and gender differences in facial anatomy. Recent MRI and ultrasound studies challenge the notion of filler breakdown, emphasizing the importance of filler selection and injection techniques. Education, individualized treatments, and a holistic understanding of facial anatomy are key to preventing and managing FOS and ensuring natural and harmonious facial aesthetics. [ABSTRACT FROM AUTHOR]

Purpose:  This prospective, single-center study aims to evaluate the safety and effectiveness of NEAUVIA Intense, a PEG cross-linked polymeric hydrogel, in correcting moderate-to-severe nasolabial folds (NLF) in a routine clinical setting. The study investigates the aesthetic outcomes, patient satisfaction, and adverse events associated with the injectable filler. Patients and Methods: Seventy patients were initially enrolled, with 60 meeting study parameters. The post-market study involved a single session treatment, employing NEAUVIA Intense on each side of the NLF. Assessments utilized the Modified Fitzpatrick Wrinkle Scale (MFWS), Global Aesthetic Improvement Scale (GAIS), and Visual Analogical Scale (VAS). Results:  The study demonstrated a statistically significant improvement in tissue depression immediately post-injection (p < 0.001), with sustained effects up to 6 months. MFWS assessments revealed that responder patients were 96.6% immediately after treatment, 76.6% one month, 48.3% after  3 months, and 28.3% at  6 months (p < 0.001). Additionally, there was a significant change in the frequency distribution of MFWS scores post-treatment (p < 0.001), with the majority of patients experiencing improvement in tissue depression. Maximum improvement was observed at 30- and 90-days post-treatment based on GAIS assessments. Patient and physician satisfaction, measured by VAS, remained stable over time, with fluctuations at 4 and 24 weeks after treatment (p < 0.001, Anova; p < 0.05, Wilcoxon). Throughout the entire follow-up duration of the patients enrolled in the study, no adverse effects related to the use of the product were observed. Conclusion:  NEAUVIA Intense proved to be an effective solution for correcting NLF, providing significant and lasting improvements in tissue depression and aesthetic outcomes. The study underscores the necessity for continuous assessment in aesthetic medicine to align outcomes with evolving patient expectations and optimize long-term results. The findings contribute to the understanding of this specific hydrogel filler and highlight the broader context of injectable fillers in comprehensive facial aesthetic strategies. [ABSTRACT FROM AUTHOR]

Zhanyi Zhang,1 Mengyuan Li,2 Yujia Geng,1 Wangshu Wang,1 Weihao Wang,1 Ying Shao1 1Department of Plastic and Reconstructive Surgery, the First Hospital of Jilin University, Changchun, Jilin Province, 130000, People’s Republic of China; 2College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun, Jilin Province, 130118, People’s Republic of ChinaCorrespondence: Ying Shao, Department of Plastic and Reconstructive Surgery, the First Hospital of Jilin University, Changchun, Jilin Province, 130000, People’s Republic of China, Email shao_ying@jlu.edu.cnPurpose: Previous studies have suggested a relationship between autoimmune diseases and the risk of facial skin aging. However, evidence from population-based studies on this topic is limited, leaving the causal association between these factors unknown. This study aimed to systematically evaluate the causal effects of 18 autoimmune diseases on the risk of facial skin aging, aim of providing strategies to mitigate early facial aging in patients with autoimmune diseases.Patients and Methods: We conducted univariate Mendelian randomization (UVMR) analyses to examine the causal relationship between 18 autoimmune diseases and facial aging using publicly available summary data from genome-wide association studies (GWASs). We also conducted multivariate Mendelian randomization (MVMR) analyses to adjust for confounding factors, including smoking, alcohol consumption, and body mass index (BMI).Results: The main inverse variance weighted (IVW) method revealed that genetically proxied ankylosing spondylitis (AS) (OR 1.017; 95% CI: 1.003– 1.031; P=0.018), sicca syndrome (SS) (OR 1.008; 95% CI: 1.005– 1.011; P= 2.66× 10− 6), systemic lupus erythematosus (SLE) (OR 1.006; 95% 1.001– 1.011; P=0.014), multiple sclerosis (MS) (OR 1.004; 95% CI: 1.001– 1.007; P=0.021), primary sclerosing cholangitis (PSC) (OR 1.002; 95% CI: 1.000– 1.004; P=0.023), and celiac disease (CeD) (OR 1.002; 95% CI: 1.001– 1.004; P=0.009) were significantly associated with higher risk of facial aging. After adjusting for potential confounding factors, the association persisted between AS, SLE, and CeD.Conclusion: These findings indicated that autoimmune diseases play a causal role in facial skin aging. Therefore, patients with autoimmune diseases should take appropriate measures to prevent early facial aging.Keywords: autoimmune disease, facial aging, Mendelian randomization, ankylosing spondylitis, systemic lupus erythematosus, celiac disease

Infraorbital groove and hollowness are common aging-related anatomical changes in the periorbital region, leading to a sunken and tired appearance. These conditions are caused by the progressive loss of volume in the deep fat pads, including the sub-orbicularis oculi fat (SOOF) and malar fat, along with skin thinning and decreased elasticity. Filler injections, particularly hyaluronic acid-based fillers, are the preferred treatment to restore volume and smooth the under-eye area. Proper diagnosis, understanding of anatomical variations, and accurate injection techniques are essential to avoid complications and achieve natural, esthetically pleasing outcomes. Treatments should consider the patient’s unique anatomy and potential adjunctive procedures to ensure balanced and harmonious facial rejuvenation.

Background: The Restylane portfolio of soft tissue fillers spans a wide range of indications, due in part to their complementary manufacturing technologies [non‐animal stabilized hyaluronic acid (NASHA) and Optimal Balance Technology (OBT/XpresHAn)]. Using an array of products, injectors can achieve a holistic, natural looking effect for their patients. However, with a wide range of products it may be difficult to choose an optimal combination. Aim: Simplify and align global use recommendations for NASHA versus OBT products. Methods: Two pre‐meeting surveys were completed by 11 key opinion leaders with international representation, with the goal of collecting information regarding their current injection practices for various anatomical regions of the face (i.e., temporal region, forehead, tear trough, lateral zygoma, anteromedial cheek, nose, pyriform aperture, nasolabial fold, perioral area, lips, labiomental crease, marionette lines, chin, and jawline). The data collected from these surveys was subsequently discussed in a consensus group meeting involving 11 voting members and 3 nonvoting members. Results: Top product recommendations were identified for each anatomical area, along with secondary and tertiary recommendations that can also be used under defined circumstances. Recommendations were provided based on a consideration of elements such as patient features (e.g., skin thickness, bone structure), the desired aesthetic outcome, experience of the injector, and the preferred injection technique. Conclusion: A majority consensus regarding the top NASHA versus OBT product choice for each anatomical region of the face was reached. These recommendations represent international agreement regarding the use of Restylane products. [ABSTRACT FROM AUTHOR]

Background: Emerging observational studies showed an association between dyslipidemia and aging. However, it remains unclear whether this association is causal, particularly in the case of Asians, which are aging more rapidly than other continents. Given the visible manifestations of aging often include changes in facial appearance, the objective of this study is to assess the causal relationship between dyslipidemia and facial aging in East Asian populations. Methods: SNPs related to dyslipidemia in East Asian people such as Total cholesterol (TC), High‐density‐lipoprotein cholesterol (HDL), Low‐density‐lipoprotein cholesterol (LDL), and Triglyceride (TG) along with outcomes data on facial aging, were extracted from public genome‐wide association studies (GWAS). A two‐sample Mendelian randomization (MR) analysis was then performed using publicly available GWAS data to investigate the potential causal relationship. The effect estimates were primarily calculated using the fixed‐effects inverse variance weighted (IVW) method. Results: Totally, 88 SNPs related to HDL among 70657 East Asian participants in GWAS. Based on the primary causal effects model using MR analyses with the IVW method, high HDL level was demonstrated as significantly related to the risk of facial aging (OR, 1.060; 95% CI, 1.005–1.119, p = 0.034), while high TC level (OR, 0.995; 95% CI, 0.920–1.076, p = 0.903), high LDL level (OR, 0.980, 95% CI, 0.924–1.041, p = 0.515), as well as high TG level (OR, 0.999, 95% CI, 0.932–1.071, p = 0.974), showed no significant correlation with facial aging. Conclusions: The two‐sample MR analysis conducted in this study revealed a positive causal relationship between high HDL levels and facial aging. In contrast, facial aging demonstrated no significant correlation with high levels of TC, LDL, or TG. Further large‐sample prospective studies are needed to validate these findings and to provide appropriate recommendations regarding nutrition management to delay the aging process among old patients in East Asia. [ABSTRACT FROM AUTHOR]

Our study aimed to clarify the anatomical features of the zygomatic, upper masseteric, lower masseteric and mandibular ligaments and their possible contribution to age-related gravitational ptosis. The study was carried out by the method of layered dissection of fresh cadavers. In several observations, the zygomatic ligament is represented by the fibers originating from the zygomaticus major muscle fibers. It is a true ligament with the fibers inserted directly into the skin. The upper and lower masseteric ligaments originate from the parotideomasseteric fascia and weave into the thickness of the SMAS. The mandibular ligament consists of two connective tissue laminae originating from the parotideomasseteric fascia at the lower edge of the mandible and from the inner surface of this fascia, along the anterior edge of the masseter muscle, skirting the facial vein sheath and the facial artery, traveling toward the platysma and the depressor anguli oris muscle, and merging with their fibers. The zygomatic ligament should be considered an osteo-musculocutaneous ligament, emphasizing the role of the associated zygomaticus major muscle in the mechanism of aging. The upper and lower masseteric and mandibular ligaments are false fascio-SMAS ligaments rather than osteo-cutaneous ones, playing the barrier role and fixing the superficial fascia and the platysma muscle. [ABSTRACT FROM AUTHOR]

Background: Several recent observational studies have associated obesity, lifestyle factors (smoking, sleep duration, and alcohol drinking), and glycemic traits with facial aging. However, whether this relationship is causal due to confounding and reverse causation is yet to be substantiated. Aims: We aimed to assess these relationships using Mendelian randomization (MR). Methods: For the instrumental variables, this paper selected independent single nucleotide polymorphisms (SNPs) linked to the exposures at a genome-wide state (P < 5 × 10−8) in equivalent genome-wide association studies (GWAS). Using the UK Biobank, we obtained summary-level data for facial aging on 423,999 individuals. The primary assessments were performed through the combination of complementing techniques (simple method approaches, weighted model, MR-Egger, and weighted median) and the inverse-variance-weighted method. Along with that, we examined the heterogeneity and horizontal pleiotropy through different types of sensitivity analyses. Results: The correlations were (a) facial aging for body mass index (BMI, OR = 1.054, 95% CI 1.044–1.64), (b) waist/hip ratio (OR = 1.056, 95% CI 1.023–1.091), and (c) smoking (OR = 1.023, 95% CI 1.007–1.039). Equally important, the correlations for waist/hip ratio remained robust after adjusting for the genetically predicted BMI (OR = 1.028, 95% CI 1.003–1.054). However, no causal effects of alcoholic drinking, glycemic traits, and sleep duration on facial aging were observed. Conclusions: The outcomes shed light on the potential correlation of obesity and cigarette smoking with facial aging while putting forward a more comprehensive and credible foundation for the optimization of facial aging strategies. No Level Assigned: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. 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. [ABSTRACT FROM AUTHOR]

Background: The use of non‐ablative fractionated lasers for skin rejuvenation has been proven to be effective in improving skin texture, and has become popular due to minimal wounding, significantly shorter recovery times and decreased adverse effects. Objective: To retrospectively analyze improvement in skin texture in healthy women aged over 18 years with Fitzpatrick skin types II–IV. Methods: Participants received three facial and/or neck treatments with the 1570‐nm fractional scanning diode laser at 1‐month intervals. Three months after the last treatment session two blinded evaluators assessed skin improvement using before and after photos. Pain and patient satisfaction were recorded. Results: Sixteen women with a mean age of 45.4 ± 4.1 years (range 35–50 years) and skin type II–IV were included in the analysis. All 16 participants received facial treatments and seven (43.8%) also received neck treatments. Three months follow‐up evaluation showed that the majority of participants had a visible change in the treated areas. Mean pain score was low and decreased with each treatment session. Conclusion: Skin treatment using fractional scanning 1570‐nm diode laser improves skin laxity in women with skin types II–IV. Larger studies are warranted to further clarify the efficacy and safety of this modality. [ABSTRACT FROM AUTHOR]

Facial aging prompts a shift in the demands for lifting procedures, transitioning from targeted improvements in younger individuals to overall facial contour enhancements as skin elasticity declines in later years. This paper examines the evolution of PDO volumizing threads, delineating their development from initial limitations to contemporary innovations aimed at addressing tissue deformation and maintaining thread integrity post‐insertion. Categorizing these threads based on elasticity, shape, and functionality underscores their versatility and application nuances, catering to specific wrinkle correction, contour sculpting, and facial volume restoration. The discussion emphasizes the pivotal role of thread characteristics in achieving optimal outcomes while minimizing potential complications. By delving into historical contexts, mechanisms, effectiveness, and thread classification, this paper equips practitioners with a comprehensive understanding to make informed decisions in selecting threads for volumizing thread procedures. Recommendations for future research directions, including long‐term safety assessments and patient‐specific outcomes, seek to enhance the clinical utility and applicability of this analysis. [ABSTRACT FROM AUTHOR]

Background: The 1064 nm Q-switched neodymium-doped yttrium aluminum garnet (QS Nd:YAG) laser was developed to treat unwanted pigmentation in the skin such as lentigines caused by photoaging, and tattoos from dye/ink insertion. This laser has also been used for non-ablative epidermal rejuvenation (skin toning). Objective: To evaluate changes in skin tone, skin texture and overall improvement after a series of treatments with the QS Nd:YAG laser. Methods: Participants received seven full-face treatments with M22 or Stellar M22, a 1064 nm QS Nd:YAG laser, at 2-week intervals. The investigators and participants evaluated the improvement in skin tone and texture at 1, 3 and 6 months after the last treatment. Patient satisfaction, patient discomfort, downtime and adverse events were recorded. Histological changes in the treated area were also evaluated. Results: Thirteen women with a median age of 45 years (range, 34–61 years) were included in the study. The majority of the participants (53.9%) had skin type VI. One month after the last treatment session, 38% of participants reported good to very good improvement. This value increased to 100% participant improvement at both the 3-month and 6-month follow-up visits. The reduction in melanin index and the histological analysis demonstrated that the laser procedure contributed to a reduction in epidermal melanin content. Treatments were not associated with high levels of pain or discomfort. The most common immediate post-treatment response was erythema and edema. Most participants were satisfied with the resulting treatment outcome. Conclusion: Skin treatment with the 1064 nm QS Nd:YAG laser module on the M22 and Stellar M22 devices, using a large spot size, low fluence, moderately high repetition rate, improves skin tone and texture in patients with skin types II–VI. [ABSTRACT FROM AUTHOR]

Addressing the intricacies of facial aging in forensic facial recognition, traditional sketch portraits often fall short in precision. This study introduces a pioneering system that seamlessly integrates a de-aging module and a sketch generator module to overcome the limitations inherent in existing methodologies. The de-aging module utilizes a deepfake-based neural network to rejuvenate facial features, while the sketch generator module leverages a pix2pix-based Generative Adversarial Network (GAN) for the generation of lifelike sketches. Comprehensive evaluations on the CUHK and AR datasets underscore the system’s superior efficiency. Significantly, comprehensive testing reveals marked enhancements in realism during the training process, demonstrated by notable reductions in Frechet Inception Distance (FID) scores (41.7 for CUHK, 60.2 for AR), augmented Structural Similarity Index (SSIM) values (0.789 for CUHK, 0.692 for AR), and improved Peak Signal-to-Noise Ratio (PSNR) metrics (20.26 for CUHK, 19.42 for AR). These findings underscore substantial advancements in the accuracy and reliability of facial recognition applications. Importantly, the system, proficient in handling diverse facial characteristics across gender, race, and culture, produces both composite and hand-drawn sketches, surpassing the capabilities of current state-of-the-art methods. This research emphasizes the transformative potential arising from the integration of de-aging networks with sketch generation, particularly for age-invariant forensic applications, and highlights the ongoing necessity for innovative developments in de-aging technology with broader societal and technological implications.

Loy Eid,&ast; Xiyuan Mao,&ast; Binfan Zhao, Jiayi Mao, Shutong Qian, Yuyu Zhang, Ying Zhang, Lu Zhang, Liying Cheng, Yuguang Zhang, Xiaoming Sun Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yuguang Zhang; Xiaoming Sun, Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai, People’s Republic of China, Email zhangyg18@126.com; drsunxm@126.comBackground: Facial fat compartments and their role in facial aging have gained increased recognition and are playing a significant role in facial rejuvenation. The superficial fat compartments glide inferiorly during the aging process, leading to the flattening and elongation of the face and the appearance of facial bulges, folds, and grooves.Patients and Methods: Ultrasound imaging of the facial soft tissues was performed on nine female volunteers to demonstrate the change in superficial facial fat compartments from an upright to supine position. The net suture jowl and medial cheek fat compartment repositioning technique was operated on 165 Asian patients between September 2020 and July 2021. Volume and projection change of malar and jowl regions, as well as change in elevation of malar protrusion were measured 1, 3, and 6 months postoperatively using a three-dimensional imaging system.Results: Ultrasound measurements confirmed the medial and middle cheek, nasolabial, and jowl fat compartments changed in thickness during positional changes with age-related differences. Postoperative three-dimensional imaging showed volume and projection increase in the malar region (2.23mL and 1.11mm) and decrease in the jowl region (− 0.18mL and − 0.52mm) by the 6-month follow-up date, and malar projection saw a superior displacement of 3.08mm.Conclusion: The superficial fat glide inferiorly within their compartments under the force of gravity and naturally reposition themselves when the effect of gravity is reversed. The net suture technique offers a minimally invasive method for lifting the jowl fat, volumizing the mid-cheek and achieving facial rejuvenation by repositioning the superficial fat compartments.Keywords: fat compartments, facial rejuvenation, face lift, facial aging

ABSTRACT Purpose To evaluate the efficacy of grafting a preseptal strip of orbicularis muscle to treat deep static glabellar wrinkles. Methods This was a prospective, interventional, case series study that included patients aged between 21 and 80, who underwent upper and lower blepharoplasty, and who presented varying degrees of deep static glabellar rhytids. After marking the glabellar rhytid, a subcision was made with 40 x 12mm needle along the entire length of the glabellar wrinkle. The orbicularis muscle graft was set into the recipient pocket already created in the glabella. The patients answered a self-assessment form about the results using the subject Global Aesthetic Improvement Scale after 6 months. Results Seventeen glabellar rhytid fillings were performed. As for the subjective evaluation of the result of the specific glabella filling procedure, the patients were distributed as follows: 12 rhytids (70.6%; 12 out of 17) were self-assessed as much better; 4 rhytids (23.6%; 3 out of 17) were self-assessed as better, and 1 rhytid (5.8%; 1 of 17) was self-assessed as unchanged. Conclusion This technique has excellent results, is easy to perform, has low morbidity and presents a high degree of satisfaction when patients evaluated themselves.

Copyright of Revista Brasileira de Oftalmologia is the property of Sociedade Brasileira de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To evaluate the perceived age of patients before and after functional upper blepharoplasty. Retrospective chart review of patients who underwent upper blepharoplasty by a single surgeon at an academic center. The inclusion criterion was having external photographs before and after blepharoplasty. Exclusion criteria included any other concurrent eyelid or facial surgery. Primary endpoint: perceived change in age after surgery as judged by the American Society of Ophthalmic Plastic & Reconstructive Surgery (ASOPRS) surgeons. Sixty-seven patients (14 men, 53 women) were included. Mean pre-operative age was 66.9 years (range 37.8–89.4) and mean post-operative age was 67.4 years (range 38.6–89). The mean perceived age pre-operatively was 68.9 years, and the mean perceived age post-operatively was 67.1 years, a change of 1.8 years (p = 0.0001 by two-tailed paired T-test). Inter-rater reliability of the observers was measured by intraclass correlation coefficient of 0.77 for pre-operative and 0.75 for post-operative photos. The decreased perceived age was 1.9 years for women, 1.4 years for men, 0.3 years for Asians, 1.2 years for Hispanics, and 2.1 years for whites. Functional upper blepharoplasty by an experienced ASOPRS surgeon was shown to reduce the perceived age of a patient by an average of 1.8 years. [ABSTRACT FROM AUTHOR]

Background: A previous injection algorithm termed the "Toxin Lift" was recently introduced and described volume increases in the midface following neuromodulator treatments of the jawline. Increase in midfacial volume due to soft tissue repositioning could also affect the severity of infraorbital hollows. Objective: The objective is therefore to evaluate whether the severity of infraorbital hollows can be improved by injecting neuromodulators in the supra‐mandibular segment of the platysma. Materials and Methods: A total of 35 volunteers (11 males/24 females) with a mean age of 39.8 (9.6) years and a mean BMI of 25.2 (5.2) kg/m2 were investigated. Bilateral infraorbital regions were evaluated via clinical assessment and semi‐quantitative 3D imaging. The applied injection technique targeted the platysma via four injection points administering 5 I.U. per injection point resulting in a total of 20 I.U. per facial side. Results: Volume increase of the infraorbital region was 0.13 cc at 15 days (p = 0.001) and was 0.02 cc at 30 days (p = 0.452) whereas the skin displacement in cranial direction was 0.54 mm at 15 days (p < 0.001) and was 0.31 mm at 30 days (p < 0.001). Clinical evaluation revealed a highly statistically significant improvement of the tear trough, palpaebromalar groove, and of the lid‐cheek junction when compared to baseline with all p < 0.001. Conclusion: The results of this clinical prospective interventional analysis revealed that the "Toxin Lift" injection technique is capable to improve the clinical appearance of infraorbital hollows. The effects can be explained by the concepts of facial biomechanics. [ABSTRACT FROM AUTHOR]

Chemical peeling treats facial cutaneous aging and may avoid risks in patients with sensitive skin, darker skin types, limited finances, or concern for side effects of other resurfacing techniques. Tolerability and improvement of photoaging using a combination peel containing 6% trichloroacetic acid and 12% lactic acid for treatment of mild‐to‐moderate signs of facial photoaging were assessed. This is a prospective, single‐center, single‐arm, study of 32 female subjects with mild‐to‐moderate signs of facial aging and Fitzpatrick Skin Types I–V treated with three monthly treatments of a combination peel containing 6% trichloroacetic acid and 12% lactic acid. After 3 treatments, there were statistically significant improvements in clarity, brightness, redness, pigmentation, fine lines, tactile and visual roughness, and overall appearance scores. Subjective improvements in photoaging parameters varied from 53% (fine lines) to 91% (clarity/brightness). Three treatments with a combination peel containing 6% trichloroacetic acid and 12% lactic acid achieved improvements in signs of facial photoaging. This procedure is safe and effective at treating cutaneous aging for all skin types and a viable option for patients who wish to avoid other resurfacing techniques such as laser resurfacing, microneedling among others. [ABSTRACT FROM AUTHOR]

L'expérience de l'auteur date de 1990, période où il prenait en charge la féminisation du squelette faciale afin d'améliorer l'intégration sociale des patients transsexuelles masculins. Très rapidement, ces techniques ont été étendues aux femmes génétiques souhaitant un visage plus féminin. Cette chirurgie du squelette faciale a ensuite été complétée par une chirurgie des parties molles. Cette chirurgie squelettique et volumétrique est devenue un apport important dans la recherche du rajeunissement facial et de la beauté. The author's experience dates from 1990, during the period when he was in charge of the feminization of the facial skeleton in order to improve the social integration of male transsexual patients. Very quickly, these techniques were extended to genetic women who wanted a more feminine face. This facial skeletal surgery was then supplemented with soft tissue surgery. This skeletal and volumetric surgery has become an important contribution in the search of facial rejuvenation and beauty. [ABSTRACT FROM AUTHOR]

Copyright of Health & Society is the property of Instituto de Ensino e Pesquisa Periodicojs and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Health & Society is the property of Instituto de Ensino e Pesquisa Periodicojs and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Aging is an inescapable process, but it can be slowed down, particularly facial aging. Sex and growth hormones have been shown to play an important role in the process of facial aging. We investigated this association further, using a two-sample Mendelian randomization study. Methods: We analyzed genome-wide association study (GWAS) data from the UK Biobank database comprising facial aging data from 432,999 samples, using two-sample Mendelian randomization. In addition, single-nucleotide polymorphism (SNP) data on sex hormone-binding globulin (SHBG) and sex steroid hormones were obtained from a GWAS in the UK Biobank [SHBG, N = 189,473; total testosterone (TT), N = 230,454; bioavailable testosterone (BT), N = 188,507; and estradiol (E2), N = 2,607)]. The inverse-variance weighted (IVW) method was the major algorithm used in this study, and random-effects models were used in cases of heterogeneity. To avoid errors caused by a single algorithm, we selected MR-Egger, weighted median, and weighted mode as supplementary algorithms. Horizontal pleiotropy was detected based on the intercept in the MR-Egger regression. The leave-one-out method was used for sensitivity analysis. Results: SHBG plays a promoting role, whereas sex steroid hormones (TT, BT, and E2) play an inhibitory role in facial aging. Growth hormone (GH) and insulinlike growth factor-1 (IGF-1) levels had no significant effect on facial aging, which is inconsistent with previous findings in vitro. Conclusion: Regulating the levels of SHBG, BT, TT, and E2 may be an important means to delay facial aging. [ABSTRACT FROM AUTHOR]

With age, we develop facial wrinkles, which change the appearance of the face making it less attractive. Winkles and folds also “mimic” facial expressions, such that older neutral faces appear more emotional. Both processes can influence first impressions negatively. We obtained ratings of attractiveness, closeness, and emotional expressivity as well as first impressions from 353 participants, recruited from Prolific, for avatars with and without facial wrinkles. Older appearing, wrinkled faces were judged as less attractive and less favorably on traits related to pleasantness and trustworthiness, they were perceived as showing more negative emotions and participants rated themselves as less close. The effects on first impressions and perceived closeness were mediated by attractiveness and perceived negative emotions. These findings suggest that in initial encounters older people may often be perceived as less pleasant for no other reason than the wrinkles in their face and the judgments of attractiveness and emotionality associated with them.

It is reported that overweight may lead to accelerated aging. However, there is still a lack of evidence on the causal effect of overweight and aging. We collected genetic variants associated with overweight, age proxy indicators (telomere length, frailty index and facial aging), etc., from genome‐wide association studies datasets. Then we performed MR analyses to explore associations between overweight and age proxy indicators. MR analyses were primarily conducted using the inverse variance weighted method, followed by various sensitivity and validation analyses. MR analyses indicated that there were significant associations of overweight on telomere length, frailty index, and facial aging (β = −0.018, 95% CI = −0.033 to −0.003, p = 0.0162; β = 0.055, 95% CI = 0.030–0.079, p < 0.0001; β = 0.029, 95% CI = 0.013–0.046, p = 0.0005 respectively). Overweight also had a significant negative causality with longevity expectancy (90th survival percentile, β = −0.220, 95% CI = −0.323 to −0.118, p < 0.0001; 99th survival percentile, β = −0.389, 95% CI = −0.652 to −0.126, p = 0.0038). Moreover, the findings tend to favor causal links between body fat mass/body fat percentage on aging proxy indicators, but not body fat‐free mass. This study provides evidence of the causality between overweight and accelerated aging (telomere length decreased, frailty index increased, facial aging increased) and lower longevity expectancy. Accordingly, the potential significance of weight control and treatment of overweight in combating accelerated aging need to be emphasized. [ABSTRACT FROM AUTHOR]

Background: Facial morphology changes with aging, resulting in an aged appearance that is a great matter of concern for people. However, it is not clear whether people perceive their own facial appearance accurately, in part because there are few methods to evaluate this. Aim: The aim of this study is firstly to establish an evaluation system for the perception gap of aged facial appearance between the self‐perceived status and the actual status, and then to use this evaluation system to quantify the perception gap and to clarify the mechanism of this gap Method: Thirty‐six middle‐aged female volunteers were first asked to rate their facial aging‐related morphology according to a 6‐grade set of photos taken at a 45° angle from the front showing progressive stages of sagging severity, without looking either in a mirror or at photos of themselves (self‐ or "subjective" perception). Then they were shown photos of their face taken at a 45° angle from the front, and asked again to rate their sagging grade based on these photos ("objective" rating). In addition, facial photos taken from several angles from the front to the side were evaluated for sagging severity by trained evaluators. Results: This system for analyzing perception gap revealed that the self‐perception of aged appearance was significantly younger than the actual situation in three facial areas, namely the cheek, around the eyes and the facial contour, and the gap corresponded to an age difference of as much as 8 years in middle‐aged females. Trained evaluators found that the severity of sagging judged from photos taken from a frontal direction was significantly less than in photos of the same subject taken from side angles. This suggests that recognition of sagging is more difficult from the front, which is the direction from which people view their own face in daily life. Indeed, viewing photos taken from the side, a rare viewing angle of one's own face, increased the motivation to improve aged appearance in more than 70% of the subjects in a questionnaire survey. Conclusion: The results suggest that people perceive their own facial appearance as less aged than it actually is. The reason for this appears to be that viewing from the front, the usual viewing angle of one's own face in daily life, results in lower perceived sagging severity, likely due to reduced depth perception. [ABSTRACT FROM AUTHOR]

Recently, thanks to the greater discovery of the mechanisms of facial aging, an alternative to invasive plastic surgery has found space with less invasive aesthetic procedures, also based on an increasingly pressing request. We are specifically referring to dermal filler injection into or under the skin which leads to immediate rejuvenation and aesthetic improvements. In this study, we wanted to analyze the results obtained through the use of NEAUVIA Organic Stimulate, particularly with regard to its effectiveness, which is a cross-linked polymeric hydrogel, containing stabilized sodium hyaluronate 26 mg/mL and calcium hydroxyapatite (1%), glycine and L-proline in buffer pyrogen-free water, in its main indication, namely, the temporary correction of congenital and acquired deficiencies of the soft tissues of the face by intradermal injection. Initially, 70 patients were enrolled, but 10 did not complete the study due to non-observance of the investigation rules, so they were excluded from the protocol. The collected data demonstrate an efficient mechanical effect of the pegylated polymeric acid matrix enriched with low concertation of calcium hydroxyapatite and in accordance with other evidence in vitro and in vivo, and the mechanical support of the interstitial connective space improves the homestays of the anatomical layer rebalancing the physiological activity of the dermis cells. [ABSTRACT FROM AUTHOR]

Backround: Healthy and a youthful appearance is a common desire of the aging population. "Beauty from within" involves using nutrition and nutraceuticals to support skin function for reducing and reversing signs of aging such as wrinkles, pigmentary changes, skin laxity, and dullness. Carotenoids possess strong antioxidant and anti‐inflammatory activities and are effective in improving skin barrier and could thereby stimulate "beauty from within" by providing endogenous support to reduce the expressions of aging. Aim: This study was designed to determine whether 3‐month supplementation with Lycomato would improve skin condition. Method: A panel of 50 female subjects used Lycomato capsules as nutritional supplements for 3 months. Skin status was observed via questionnaires for the assessment of skin condition and expert visual grading of facial markers such as wrinkles, tonality, roughness, laxity, and pore size. Skin barrier was assessed using transepidermal water loss (TEWL). Measurements were obtained before treatment and after 4 and 12 weeks of use. Results: Results indicated a statistically significant improvement (p < 0.05) in skin barrier as measured by TEWL after 12 weeks of consuming the supplement. There was also a significant improvement in skin tonality, lines and wrinkles, pore size, and skin firmness as observed by expert evaluation as well as subject self‐assessment. Conclusion: Based on the confines and conditions of this study, oral supplementation with Lycomato resulted in significant improvement in skin barrier. Visual appearance of lines and wrinkles, skin tonality, pores, smoothness, and firmness were considerably improved, and these improvements were found to be substantially discernible by the subjects. [ABSTRACT FROM AUTHOR]

Background: Placement of fillers in close proximity to the mimetic or sphincter muscles of the face appears to enhance or suppress muscle action in a relatively predictable way. Methods: From June 2016 to June 2021, patients who underwent the first author's technique of myomodulation with dermal fillers to address aesthetic concerns or to manage facial spasms or synkinesis were evaluated in a retrospective case series. Additionally, the authors provide a technical guide for a whole-face approach to treatment with fillers and a conceptual map for treatment of each facial subunit with a focus on myomodulation. Results: A total of 1352 patients (1108 women, 244 men; mean age, 51 years) underwent at least 1 treatment session during the 5-year study period. The treatment patterns of the study population and details of 2 representative cases are presented. Conclusions: Although not well understood mechanistically, myomodulation with injectable fillers shows promise for significant and reliable results of facial rejuvenation. Level of Evidence IV: This journal requires that 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. [ABSTRACT FROM AUTHOR]

Background: In recent years, the demand for facial rejuvenation is increasing year by year. This study aims to use bibliometric analysis to construct a visualization map of the facial rejuvenation research and provide the research hotspots and trend frontiers in the field. Methods: Publications on facial rejuvenation research were extracted from the Web of Science Core Collection database. VOSviewer 1.6.18 was used to analyze the co-authorship, the citations of countries, institutions, and authors, the co-occurrence of keywords, and the journals in which the studies were published. Results: In total, 6,196 records of facial rejuvenation research published between 2000 and 2021 were collected. The USA had published the most publications in this field (2,647), and its main partners were Canada, Germany, and China. University of California, Los Angeles, was the institution with the greatest contribution (127 publications). Plastic and Reconstructive Surgery (623 publications) published the most research in this field and was also the most frequently co-cited journal (17,349 citations, total link strength: 586,955). Rohrich RJ (70 publications) was the most prolific and most frequently co-cited author (1,230 citations, TLS: 26,603). Among the 100 most cited articles, 57 articles are amenable to grading level of evidence, and most papers presented their findings utilizing level IV evidence. Conclusions: At present, the research hotspots in this field included the following six aspects: facial photoelectric therapy, aging manifestation and treatment in the middle of the face, the application of autologous fat transfer in facial rejuvenation, facial plastic surgery, facial injection cosmetology, and rhytidectomy and related anatomy. According to the analysis of the timing diagram, the research trends were esthetic medicine, mesenchymal stem cells, laser therapy, the application of platelet-rich plasma, and platelet-rich fibrin. This journal requires that 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. Level of Evidence III: This journal requires that 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. [ABSTRACT FROM AUTHOR]

Our study aimed to clarify the anatomical features of the zygomatic, upper masseteric, lower masseteric and mandibular ligaments and their possible contribution to age-related gravitational ptosis. The study was carried out by the method of layered dissection of fresh cadavers. In several observations, the zygomatic ligament is represented by the fibers originating from the zygomaticus major muscle fibers. It is a true ligament with the fibers inserted directly into the skin. The upper and lower masseteric ligaments originate from the parotideomasseteric fascia and weave into the thickness of the SMAS. The mandibular ligament consists of two connective tissue laminae originating from the parotideomasseteric fascia at the lower edge of the mandible and from the inner surface of this fascia, along the anterior edge of the masseter muscle, skirting the facial vein sheath and the facial artery, traveling toward the platysma and the depressor anguli oris muscle, and merging with their fibers. The zygomatic ligament should be considered an osteo-musculocutaneous ligament, emphasizing the role of the associated zygomaticus major muscle in the mechanism of aging. The upper and lower masseteric and mandibular ligaments are false fascio-SMAS ligaments rather than osteo-cutaneous ones, playing the barrier role and fixing the superficial fascia and the platysma muscle.