Explore the vast range of titles available.

Background Energy‐based photoelectric and ultrasonic devices are essential for skin rejuvenation and resurfacing in the field of plastic surgery and dermatology. Both functionality and appearance are impacted by factors that cause skin to age, and various energy types have variable skin penetration depths and modes of transmission. Aim The objective is to advise safe and efficient antiaging treatment while precisely and sensitively controlling and assessing the extent of thermal damage to tissues caused by different kinds of energy‐based devices. Methods A literature search was conducted on PubMed to review the mechanisms of action and thermal effects of photoelectric and ultrasonic devices in skin remodeling applications. Results This paper reviews the thermal effects of energy‐based devices in skin resurfacing applications, including the tissue level and molecular biochemical level. It seeks to summarize the distribution form, depth of action, and influencing factors of thermal effects in combination with the mechanisms of action of various types of devices. Conclusion Accurate control of thermal damage is crucial for safe and effective skin remodeling treatments. Thorough investigation of molecular biochemical indicators and signaling pathways is needed for real‐time monitoring and prevention of severe thermal injury. Ongoing research and technological advancements will improve the accuracy and control of thermal damage during treatments.

Background Microfocused ultrasound with visualization (MFU‐V) is widely used in aesthetic medicine for skin tightening and rejuvenation. However, its role in regenerative aesthetics and its precise mechanism of action are not fully understood. Objective This narrative review aims to contextualize and articulate the mechanism of action of MFU‐V, evaluate its role in regenerative aesthetics, and assess its effectiveness based on existing clinical, histological, and skin‐mechanical studies. Methods A comprehensive literature search was performed to collect and analyze studies on MFU's biological mechanisms, clinical outcomes, and impact on extracellular matrix (ECM) regeneration. The review integrates findings from clinical trials, histological analyses, and biomechanical assessments to provide a cohesive understanding of MFU‐V's role in aesthetic medicine. Results MFU‐V emits focused ultrasound energy that penetrates multiple skin layers and the superficial musculoaponeurotic system, creating localized thermal coagulation points. These points initiate biological responses that recruit fibroblasts and stimulate the production of new collagen and elastin fibers. Enhanced ECM protein synthesis leads to significant improvements in skin biomechanics and quality, reducing skin laxity and enhancing appearance. Clinical studies support these findings, showing improvements in skin firmness and texture following MFU‐V treatment. Conclusion Through analyzing the underlying biological mechanisms and the observable clinical outcomes, this narrative review sets the stage for a comprehensive understanding of the mechanism of action and role of MFU‐V in regenerative aesthetics.

Background The use of energy‐based devices (EBDs) for aesthetic and dermatological conditions is increasing, but data on efficacy and safety in autoimmune connective tissue disease (CTD) patients remain limited. Objectives This study assesses EBD real‐world treatment outcomes in Korean patients with lupus erythematosus (LE) and dermatomyositis (DM). Methods A retrospective, uncontrolled study was conducted on 26 CTD patients (LE: 20, DM: 6) treated at Hanyang University Seoul Hospital (2015–2023). Various laser modalities, including pulsed‐dye laser (PDL), intense pulsed light (IPL), long‐pulse Nd:YAG (LPNY), Q‐switched Nd:YAG (QSNY), and ablative fractional laser (AFL), were analyzed. Two independent dermatologists evaluated treatment outcomes using a 5‐point modified Investigator's Global Assessment (IGA) scale. Results Patients showed significant improvement in erythema, dyspigmentation, and overall skin morphology. Some LE patients also exhibited enhanced follicular activity. Treatments were well‐tolerated, with only transient side effects reported, and no long‐term complications or disease reactivation occurred. Conclusions EBD treatments may provide cosmetic improvement in selected LE and DM patients and are generally safe. Larger controlled studies are needed to confirm efficacy and establish optimal protocols.

Background In recent years, treatments using energy‐based devices (EBDs) aimed at skin quality improvement have become widely adopted. However, it has been pointed out that treatments using EBDs alone show limited durability of effects and variability in patient‐perceived improvements. Therefore, we evaluated skin quality improvement resulting from a combination therapy involving cross‐linked hyaluronic acid (CL‐HA) filler and EBD treatments tailored to patients' chief concerns. Objective To assess the efficacy and safety of combined CL‐HA filler and EBD therapies in treating facial skin quality improvement among Asian subjects. Methods In this prospective, evaluator‐blinded study, 18 participants aged 32–59 years with decreased skin elasticity, fine wrinkles, uneven texture, pore enlargement, pigmentation, and sagging were enrolled. CL‐HA filler (VYC‐12L) was injected intradermally into the entire face. One month later, according to each patient's primary concerns and symptoms, EBD treatment (either high intensity, high frequency parallel ultrasound beam [PUB], picosecond alexandrite laser [PSAL], and sequential monopolar bipolar pulsed radiofrequency [SMBPRF]) was administered to the entire face. Evaluations were conducted at three time points: baseline (T0), 4 weeks post‐CL‐HA injection (T1), and 8 weeks post‐EBD treatment (T2). Subjective assessment was performed using the FACE‐Q | Aesthetics—Satisfaction with Skin scale. Objective assessment was independently conducted by a dermatologist utilizing three‐dimensional image analysis and skin diagnostic imaging with the Global Aesthetic Improvement Scale (GAIS). Results All participants completed the study. Pairwise comparisons of the FACE‐Q skin satisfaction scores demonstrated statistically significant improvements at all time points: from T0 to T1 (p < 0.05), from T0 to T2 (p < 0.001), and from T1 to T2 (p < 0.001). Objective assessment with the GAIS showed improvement in all cases: very much improved (2 cases), much improved (9 cases), improved (7 cases), no change (0 cases), and worsened (0 cases). Regarding safety, no severe adverse events were reported, and only minor transient post‐treatment reactions were observed. Conclusions The combination of CL‐HA filler and EBD represents a safe and effective therapeutic approach for enhancing facial skin quality in Asian subjects.

Background Microfocused ultrasound with visualization (MFU‐V) is well established for noninvasive lifting of the face, neck, and décolleté. U.S. FDA clearance was recently granted for treatment of the abdomen and upper arms, supported by favorable safety data and emerging evidence of efficacy of its use to address skin and soft tissue laxity in body regions. Guidance on best practices for these additional indications is desirable. Aims This consensus aims to provide evidence‐based and practice‐informed recommendations supporting safe, effective, and reproducible MFU‐V treatments for the additional body indications. Methods An international, multidisciplinary panel of aesthetic experts developed consensus recommendations for MFU‐V treatment of additional body areas based on clinical evidence, expert experience, and structured virtual discussions. Results This global expert consensus affirms MFU‐V as a safe and effective noninvasive modality for treating mild to moderate skin and soft tissue laxity in the abdomen and upper arms. Three key domains were identified as critical to optimizing outcomes: patient selection, treatment planning, and expectation management. Ideal candidates are those with mild to moderate laxity and target tissues located at treatable depths. Real‐time ultrasound imaging was emphasized for accurate targeting, anatomical safety, and treatment precision. The panel developed practical treatment protocols for the abdomen and upper arms, including recommended treatment zones, line densities, and transducer depths tailored to tissue characteristics. Conclusion Safe and effective MFU‐V outcomes rely on real‐time ultrasound visualization, thoughtful patient selection, expectation management, and anatomically guided treatment. Continued research is needed to refine protocols and guide emerging body applications.

Background Energy‐based devices (EBDs) and injectable hyaluronic acid gels, such as VYC‐12L, are each effective treatment modalities for improving skin quality. Objectives To assess the rationale and potential benefits of adding VYC‐12L to EBD treatments, and consider how they can be practically integrated into a single treatment plan. Methods Eight clinicians with various specialties and extensive experience of these modalities completed a written questionnaire and were individually interviewed. Their collective clinical expertise and experience form the basis of this guidance. Results Using both VYC‐12L and EBDs within a single treatment plan offers many potential benefits for improving skin quality—based on mechanistic synergies and complementary abilities to address different attributes and multiple anatomical layers. Careful consideration should be given to appropriate sequencing. VYC‐12L and non‐ablative EBDs can be used on the same day, but treatment fields must be appropriately managed and aseptic technique rigorously upheld. When administering VYC‐12L, maintaining the correct injection depth is essential to positive outcomes. Practitioners should undertake appropriate training and select the injection tools that optimize control. Conclusions Multimodal treatment using VYC‐12L and EBDs together can provide a more comprehensive, tailored approach to skin‐quality improvement, delivering high levels of patient satisfaction.

Purpose Microfocused ultrasound with real‐time visualization (MFU‐V) is often used for noninvasive skin lifting, by precisely targeting dermal and subcutaneous tissues to create thermal coagulation points (TCPs). These TCPs denature collagen and initiate a transient inflammatory response, ultimately attracting dermal fibroblasts and inducing efficient neocollagenesis and extracellular matrix (ECM) remodeling, yielding to MFU‐V's desired skin‐lifting effects. The current study investigates MFU‐V's underlying mode of action based on the histological progression of TCPs in the skin, providing new insight into the technology's regenerative effect. Methods Following standard triple‐depth MFU‐V treatment, in vivo skin samples were assessed using histology and immunohistochemistry to evaluate TCPs, heat shock protein (HSP47), and elastin expression in fibroblasts. Results MFU‐V treatment induced elongated, flame‐like TCPs with denatured collagen at focal depths of 1.5, 3.0, and 4.5 mm within the skin—each corresponding to its respective transducer depth. Time‐dependent progression of TCPs showed significantly increased scores of fibroblasts and mature collagen along with recruitment of HSP47‐positive fibroblasts to TCP areas on Day 90. Collagen formation and later maturation were visualized. Newly synthesized elastin significantly increased in the TCP area on Day 90 compared to Day 14. Conclusion This work provides histological evidence of stimulation and regeneration of newly synthesized elastin fibers after TCP induction. MFU‐V‐generated TCPs triggered the body's own healing cascade of collagen denaturation, transient inflammation, proliferation, and tissue remodeling, resulting in attraction of HSP47‐positive fibroblasts to the TCP sites, and new collagen and elastin fiber regeneration by fibroblasts. Besides the well‐described neocollagenesis, this study demonstrates that MFU‐V treatment induces elastin neogenesis that may result not only in skin lifting but also in improved skin elasticity, providing an overall regenerative effect.

Axillary hyperhidrosis and osmidrosis are challenging to treat, and neither topical nor systemic drugs have provided optimal treatment outcomes. In the past decades, treatment with botulinum toxin (BTX) has gained status as the gold standard, but it has its limitations both in regard to duration as well as indication for osmidrosis, specifically. A variety of local interventions have been explored in both the surgical field and within energy‐based devices (EBDs) for alternative in‐office treatments, but a collective overview is lacking. This study sought to investigate and assess the evidence on and effect of current local procedures for axillary hyperhidrosis and osmidrosis. A systematic search for prospective and controlled clinical trials in the databases PubMed, Embase and Cochrane Library until 31 December 2023 was executed. Relevant literature was identified independently by two authors according to predefined inclusion and exclusion criteria. Fifty‐nine studies met the criteria for final inclusion, of which 46 studies were randomized controlled trials and 13 were nonrandomized trials. The included studies were classified by procedure type. Individually, a total of 28 studies investigated BTXs, 11 studies explored EBDs, while six studies reported on surgical interventions. Additionally, 14 studies evaluated alternative procedures or investigated combinations and side‐by‐side comparisons of the different procedure types. The dominant evidence on efficacy and safety was of BTX A. EBDs are increasingly being investigated with microwave thermolysis appearing to be the singular most established and scientifically well‐founded method. In the surgical field, less‐invasive methods are gaining ground. To meet the increasing demand for individualized treatment, additional high‐quality comparative studies are required for the establishment of a future variety of standard treatments.

Combinations of minimally invasive procedures (MIPs) are often used in aesthetic treatments and are increasingly considered as the new standard of care. Three agents with specific properties are available in this perspective: a polycaprolactone (PCL)-based collagen stimulator, a poly-L-lactic acid (PLLA)- and a poly-glycolic acid (PLGA)-based resorbable suspension suture with a 3D-cone technology, and a cross-linked hyaluronic acid (HA). To develop the first practice guidelines on rejuvenation treatment of the face and the neck using combinations of these agents, whether associated or not with other widely used MIPs such as botulinum neurotoxins or energy-based devices. A multi-disciplinary, multi-national board of plastic surgeons and dermatologists convened to develop guidelines using a predefined consensus method. The consensus was defined as ≥83% agreement rate between participants. Practice guidelines and algorithms, describing optimal procedure sequence and spacing, are proposed for the treatment of upper-, mid-, lower-face and neck, combining the PCL collagen stimulator, the PLLA/PLGA suspension sutures, and the cross-linked HA, whether associated or not with other MIPs. These new guidelines provide general support to optimal management strategies. Individual treatment plans should be adapted according to the physician's individual competence and the patient's preferences.