Microfocused Ultrasound With Visualization in Skin Quality: A Narrative Review.

Background: Skin quality is a multidimensional concept encompassing four emergent perceptual categories (EPCs): firmness, surface evenness, tone evenness, and glow. Microfocused Ultrasound with Visualization (MFU-V; Ulthera System) is a non-invasive device FDA-cleared for lifting and tightening of the skin in specific areas. Through the generation of thermal coagulation points at defined depths, MFU-V initiates neocollagenesis and elastin remodeling, which may support improvements in features related to overall skin quality.

Microvascular Insights Into Hyaluronic Acid Filler Dispersal Within an Artificial Model of Arterial Embolism.

Background: Hyaluronic acid (HA) filler-induced vascular occlusion is a serious complication in aesthetic medicine, yet the microvascular behavior of HA gels under physiologically relevant flow conditions remains poorly characterized.

Objectives: To evaluate the embolic fragmentation, dispersal, and occlusive behavior of five commercially available HA fillers within a physiologically calibrated microvascular perfusion model.

Methods: Five HA fillers were tested using a modified PULSAR system incorporating a branched microtubular adapter (200-1000 µm channels) with physiologic arterial flow parameters.

Exploratory Analysis of Age-Related Trends in Biostimulatory Response to Combined Calcium Hydroxylapatite-Carboxymethylcellulose and Microfocused Ultrasound With Visualization Treatments.

Background: Biostimulators and energy-based devices are increasingly used in combination to address visible signs of aging. Previous research demonstrated that pairing microfocused ultrasound with visualization (MFU-V) and hyperdiluted calcium hydroxylapatite-carboxymethylcellulose (CaHA-CMC) enhances dermal elastin synthesis and improves aesthetic outcomes up to 120 days posttreatment. However, the impact of patient age on the histological response to these treatments remains unclear.

Bicomponent nano- and microfiber aerogels for effective management of junctional hemorrhage.

Managing junctional hemorrhage is challenging due to ineffective existing techniques, with the groin being the most common site, accounting for approximately 19.2% of potentially survivable field deaths. Here, we report a bicomponent nano- and microfiber aerogel (NMA) for injection into deep, narrow junctional wounds to effectively halt bleeding.

A novel empirical and rheometric assessment of viscoelastic hydrogel implant cohesiveness.

Therapeutic implantable hydrogels are increasingly utilized in medicine due to their versatile viscoelastic properties. Nonetheless, the clinical efficacy and longevity of these products is predicated on their ability to retain structural integrity post-implantation. Gel cohesion, defined as the capacity to resist fragmentation, has lacked empirical standardization, especially in high shear environments, with present methods often conflating this mechanical parameter with gel ductility or qualitative perceptions of tackiness.

Microfocused Ultrasound in Regenerative Aesthetics: A Narrative Review on Mechanisms of Action and Clinical Outcomes.

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.

Granular Porous Nanofibrous Microspheres Enhance Cellular Infiltration for Diabetic Wound Healing.

Diabetic foot ulcers (DFUs) are a significant challenge in the clinical care of diabetic patients, often necessitating limb amputation and compromising the quality of life and life expectancy of this cohort. Minimally invasive therapies, such as modular scaffolds, are at the forefront of current DFU treatment, offering an efficient approach for administering therapeutics that accelerate tissue repair and regeneration. In this study, we report a facile method for fabricating granular nanofibrous microspheres (NMs) with predesigned structures and porosities.

The Impact of Gel Parameters on the Dispersal and Fragmentation of Hyaluronic Acid Gel Fillers within an Artificial Model of Arterial Embolism.

Accidental arterial embolization of hyaluronic acid (HA) fillers can lead to severe complications, including skin ischemia, blindness, and stroke. Currently, the intra-arterial dispersal and fragmentation behavior of HA gels is unknown but critical to our understanding of the pathomechanism of these injuries. This work introduces the Pulsatile Unit for the Laboratory Simulation of Arterio-embolic Restrictions (PULSAR) and evaluates the intravascular behavior of different HA gels.

Comparative Rheology of Hyaluronic Acid Fillers, Poly-l-lactic Acid, and Varying Dilutions of Calcium Hydroxylapatite.

Background: This study examines the rheological properties of various dermal fillers, including hyaluronic acid (HA) fillers, poly-L-lactic acid (PLLA), and calcium hydroxylapatite-carboxymethylcellulose (CaHA-CMC) gels, with a particular focus on the impact of aqueous dilution on CaHA-CMC's rheology and potential clinical implications.

Methods: Using standardized rheological analysis, we measured and compared the elastic modulus (G'), viscous modulus (G″), and the tan δ values of different dilutions of CaHA-CMC against published values of HA and PLLA fillers. The study aimed to determine the potential clinical use of application-specific CaHA-CMC hydrogel dilutions along a range of gel strength and cohesion for hydrogel fillers in current use.

Guided SEFFI and CaHA: A Retrospective Observational Study of an Innovative Protocol for Regenerative Aesthetics.

: This retrospective observational study sought to determine the efficacy and safety of an innovative combined treatment protocol using guided Superficial Enhanced Fluid Fat Injection (SEFFI) and calcium hydroxylapatite (CaHA) in facial rejuvenation. : A total of 158 patients (149 females and 9 males) underwent the combined treatment of guided SEFFI and diluted/hyperdiluted CaHA. The study evaluated treatment outcomes at 30, 90, and 150 days post-treatment using the Global Aesthetic Improvement Scale (GAIS) and three-dimensional photogrammetric analysis.

Hyperdiluting Calcium Hydroxylapatite With Platelet-Rich Plasma and Hyaluronidase for Improving Neck Laxity and Wrinkle Severity.

The two cases discussed in this report investigate the efficacy and safety of a novel injectable therapy for treating neck wrinkles and skin laxity, utilizing a combination of hyperdiluted calcium hydroxylapatite (CaHA), platelet-rich plasma (PRP), and hyaluronidase. Two patients presenting with moderate neck wrinkles and laxity underwent treatment and were evaluated several months later. The combined therapy demonstrated improvements in skin texture and laxity following a single treatment.

Improved brachial skin hydration and appearance with hyperdiluted calcium hydroxylapatite.

Introduction: The search for minimally invasive treatments for areas not covered by clothing, such as the arms, has increased, particularly to combat flaccidity resulting from factors such as aging and weight loss. This study evaluated the efficacy of calcium hydroxyapatite (CaHA), an injectable biostimulator, in improving flaccidity and hydration of the skin of the arms.

Materials And Methods: Six women between 40 and 50 years old with visible signs of brachial flaccidity were selected.

A morphological analysis of calcium hydroxylapatite and poly-l-lactic acid biostimulator particles.

Injectable fillers, pivotal in aesthetic medicine, have evolved significantly with recent trends favoring biostimulators like calcium hydroxylapatite (CaHA-CMC; Radiesse, Merz Aesthetics, Raleigh, NC) and poly-l-lactic acid (PLLA; Sculptra Aesthetics, Galderma, Dallas, TX). This study aims to compare the particle morphology of these two injectables and examine its potential clinical implications. Utilizing advanced light and scanning electron microscopy techniques, the physical characteristics of CaHA-CMC and PLLA particles were analyzed, including shape, size, circularity, roundness, aspect ratio, and quantity of phagocytosable particles.

Successful Treatment of Noninflammatory CaHA Nodules Using Focused Mechanical Vibration.

Noninflammatory nodules arising from the injection of biostimulatory fillers persist as an unwanted complication. Pathologically, noninflammatory nodules may arise from superficial injection, accidental boluses, or incorrect concentration of microparticles contained within the filler. This case report introduces a method for reversing calcium hydroxylapatite (CaHA) using focused mechanical vibration.

A Structured Approach for Treating Calcium Hydroxylapatite Focal Accumulations.

Background: Radiesse, a widely utilized calcium hydroxylapatite (CaHA) dermal filler, has shown effectiveness in soft tissue augmentation and regeneration. As with all dermal fillers, the potential for nodules may arise. Understanding the pathogenesis of these nodules and exploring effective treatment methodologies are crucial for optimizing patient outcomes.

Dilutional rheology of Radiesse: Implications for regeneration and vascular safety.

Background: Calcium hydroxylapatite-carboxymethylcellulose (CaHA-CMC) injectables have emerged as dual-purpose fillers with bioregenerative and direct filling capabilities.

Aims: This study investigates the rheological properties of CaHA-CMC and its CMC carrier gel at various dilutions.

Methods: The storage modulus (G'), loss modulus (G″), complex viscosity (η*), loss factor (tan δ), cohesivity, and extrusion force were evaluated for a range of CaHA-CMC aqueous dilutions with an oscillatory rheometer, drop weight testing, and force analysis, respectively.

Social Interest Data as a Proxy for Off-Label Performance-Enhancing Drug Use: Implications and Clinical Considerations.

Performance-enhancing drugs (PEDs) can be categorized into various classes based on the physiological mechanism of the compound, with the most popular being anabolic steroids, selective androgen receptor modulators, and growth hormones. Ancillary compounds, such as selective estrogen receptor modulators (SERMs) and selective estrogen receptor degraders, are commonly utilized alongside a PED to counterbalance any potential undesired side effects. With little clinically relevant data to support the use of these ancillary compounds, medical education and evidence-based approaches aimed at monitoring the potential adverse effects of PED use are sparse.

Hierarchically Assembled Nanofiber Scaffolds with Dual Growth Factor Gradients Promote Skin Wound Healing Through Rapid Cell Recruitment.

To address current challenges in effectively treating large skin defects caused by trauma in clinical medicine, the fabrication, and evaluation of a novel radially aligned nanofiber scaffold (RAS) with dual growth factor gradients is presented. These aligned nanofibers and the scaffold's spatial design provide many all-around "highways" for cell migration from the edge of the wound to the center area. Besides, the chemotaxis induced by two growth factor gradients further promotes cell migration.

Mechanically resilient hybrid aerogels containing fibers of dual-scale sizes and knotty networks for tissue regeneration.

The structure and design flexibility of aerogels make them promising for soft tissue engineering, though they tend to come with brittleness and low elasticity. While increasing crosslinking density may improve mechanics, it also imparts brittleness. In soft tissue engineering, resilience against mechanical loads from mobile tissues is paramount.

Anti-Inflammatory Peptide-Conjugated Silk Fibroin/Cryogel Hybrid Dual Fiber Scaffold with Hierarchical Structure Promotes Healing of Chronic Wounds.

Chronic wounds resulting from diabetes, pressure, radiation therapy, and other factors continue to pose significant challenges in wound healing. To address this, this study introduces a novel hybrid fibroin fibrous scaffold (FFS) comprising randomly arranged fibroin fibers and vertically aligned cryogel fibers (CFs). The fibroin scaffold is efficiently degummed at room temperature and simultaneously formed a porous structure.