A well-defined jawline improves overall facial aesthetics, motivating patients to seek jawline augmentation. read more
Hyaluronic acids (HAs) continue to be the fillers of choice worldwide and their popularity is growing. Adverse events (AEs) are able to be resolved through the use of hyaluronidase (HYAL). However, routine HYAL use has been at issue due to perceived safety issues. read more
Since its discovery as a facial aesthetic treatment >30 years ago, onabotulinumtoxinA has received worldwide approval for dynamic upper facial line treatment. read more
Facial filler injection techniques that help decrease the risk of vascular occlusion are an important growing area of study. This study demonstrates a model of injecting fillers into a simulated bifurcated arterial system, using different sized needle gauges at a constant injection pressure. read more
Plasmodium falciparum (Pf) is the leading protozoan causing malaria, the most devastating parasitic disease. To ensure transmission, a small subset of Pf parasites differentiate into the sexual forms (gametocytes). Since the abundance of these essential parasitic forms is extremely low within the human host, little is currently known about the molecular regulation of their sexual differentiation, highlighting the need to develop tools to investigate Pf gene expression during this fundamental mechanism. read more
Nonsurgical rhinoplasty (NSR) is an alternative to surgical rhinoplasty for patients who desire correction of mild-to-moderate aesthetic nasal defects but do not wish to undergo surgery due to concern about risks, recovery time, or cost. Although not a surrogate, NSR can be a more accessible and more precise modality for achieving aesthetic goals. Furthermore, for certain types of defects, the precision possible with filler injection versus surgery can make NSR the preferred procedure. In these instances, polymethylmethacrylate (PMMA)-collagen gel is a valuable tool for appropriate candidates due to its permanence and its favorable safety profile when injected appropriately. read more
A global approach to facial rejuvenation involves multiple treatment modalities. read more
Aspiration is a safety maneuver prior to filler injection in widespread use throughout the world, despite an absence of scientific evidence to its efficacy. This editorial questions the practice from a logical as well as a scientific point of view. read more
Hyaluronic acid (HA) fillers are a relatively safe and effective means of cosmetic treatment for the face; however, as the numbers of both patients and injectors continue to rise, reports of adverse events (AEs) and ischemia are increasing. Although visual complications and stroke are the most-feared AEs, skin and underlying tissue necrosis is far more common and can be catastrophic. HA can be dissolved with hyaluronidase, but this does not always resolve ischemia. In some instances, including the case presented here, conventional interventions are inadequate to reverse the progression of ischemia and restore blood flow. In this case study, HA injection of the nasal sidewall resulted in ischemia and impending necrosis of the nasal tip. Following failure of standard-of-care measures to reverse the progression of ischemia and restore blood flow, therapy was successfully used as an adjuvant treatment. To our knowledge, this is the first report of therapy for treatment of ischemia and necrosis from aesthetic filler injection. Based on experience here, this approach should be considered for patients who are out of therapeutic options, or as a helpful adjunct to speed resolution of vascular occlusion. In addition, the success of therapy, which acts locally on the microvasculature, may inform our understanding of the mechanism of vascular occlusion with fillers. read more
Calcium hydroxylapatite (CaHA(+); Radiesse(+) [Merz North America, Inc., Raleigh, NC]) is the first FDA-approved injectable filler for subdermal and/or supraperiosteal injection to improve moderate-to-severe loss of jawline contour. CaHA has been recognized in the past for its ability to provide contour and support overlying tissues and utilized for jawline augmentation well before this recent indication; however, with recent FDA approval of CaHA(+) for jawline contour improvement, it is important that clinicians are aware of best practices for patient selection, treatment planning and injection, as well as safety considerations and postprocedure care. read more
There is increasing demand among transgender individuals for minimally invasive aesthetic procedures, such as injectable facial fillers and neurotoxins, for facial remodeling and transformation. These procedures may increase transgender individuals' satisfaction with their appearance and allow them to more effectively harmonize their physical appearance with their perception of self. There is currently a lack of information in the medical literature regarding guidelines for the use of these products in transgender patients. In this report, the authors provide experience-based treatment considerations and recommendations for use of minimally invasive facial aesthetic procedures in transgender patients, including case studies illustrating the use of these procedures for both male-to-female and female-to-male transitioning patients. This report highlights the success of minimally invasive methods for assisting transgender patients in achieving their facial remodeling goals. Clinicians play an integral role in the transitioning process for transgender patients, and facial transformation is a key element of this process. When conducted with sensitivity and attention to individual patient goals at varying stages of transition, facial procedures can be of great benefit in enhancing patients' self-perception and overall quality of life. read more
