Facial rejuvenation is one of the most sought-out procedures in the field of aesthetic medicine and surgery. The advent of various lasers, energy-based devices, skincare products, fillers, and neuromodulators has spurred interest in rejuvenation at younger ages. Furthermore, as well as the ever-evolving range of noninvasive facial rejuvenation methods, surgical innovation in the field continues, with various facelift techniques gaining popularity. With all these interventions, an anatomic and scientific understanding of facial aging is essential to determine the best treatment plan for a patient. This article provides a scientific overview of facial aging and rejuvenation by assessing the changes to the various layers of the face with an emphasis on soft tissue and skin rejuvenation. Level of Evidence: 5 (Therapeutic).

Emphasis on clinical and patient-reported outcomes has transformed research and quality-improvement efforts, with a growing push for standardized, validated outcome measures. This scoping review aimed to evaluate whether aesthetic surgery is meeting the current scientific standard by analyzing the scientific rigor and uniformity of outcomes reported in facelift research. PubMed/MEDLINE, Embase, and Scopus were searched for US studies reporting outcomes following surgical facelifts between July 2005 and July 2025. Studies involving concurrent procedures were excluded. Study design, senior author characteristics, interventions, outcomes, measurement methods, and quality (by Methodological Index for Non-Randomized Studies [MINORS] criteria) were evaluated. Twenty-seven out of 2101 studies met inclusion criteria. Most were conducted at an academic institution (66.7%) without funding (92.6%) by a male senior author (96.3%) with a median of 21 (interquartile range, 10-34) years in practice. Retrospective designs (51.9%) outnumbered prospective (25.9%), and 48.1% were comparative. Mixed facelift techniques were described in 33.3% and unspecified in 25.9%. Clinical outcomes were reported in 70.4%, most commonly hematoma (59.3%) with only 25.0% defining measurement criteria, which all differed. Patient satisfaction was reported in 22.2%, and aesthetic outcomes in 18.5%, with validated instruments used in only 1 study for each outcome type. Most studies (63.0%) scored below the recommended MINORS thresholds for comparative and noncomparative studies (≥18 and ≥12), indicating moderate to low methodological quality. Outcome definitions and measurement methods vary substantially in facelift research. Broader use of validated instruments and standardized reporting would improve comparability across techniques and strengthen evidence-based aesthetic facial surgical interventions. Level of Evidence: 3 (Therapeutic).

Energy-based devices are widely used for facial rejuvenation; as a result, an increasing proportion of patients presenting for facelift or necklift surgery have a history of prior treatment with ultrasound- or radiofrequency-based technologies. While the efficacy and safety of these devices are well-established, their cumulative effects on facial soft tissues critical to deep-layer facelift surgery remain under-recognized. This article examines three commonly used energy-based facial tightening modalities - microfocused ultrasound, high-frequency parallel beam ultrasound, and fractional radiofrequency microneedling - from the perspective of the facelift surgeon. Device-specific mechanisms of action and tissue-level effects are reviewed, followed by discussion of their potential operative implications and the senior author's experience-informed strategies for managing these patients. Recognition of these effects is essential for patient counseling, operative planning, and preservation of long-lasting surgical outcomes.

Acute radiation dermatitis (RD) is a common and significant adverse effect experienced by patients with breast cancer undergoing radiotherapy (RT). The authors of this study investigate the efficacy and safety of a topical cream infused with exosomes derived from adipose tissue-derived mesenchymal stem cells (ASC-EXOs) in reducing radiation-induced skin damage. Fifteen patients undergoing RT applied the cream to the radiation-treated areas starting the night before treatment initiation and continued use for 2 weeks posttreatment. The severity of RD was evaluated at baseline and at Weeks 2, 4, 6, and 8, using a 5-point Radiation Therapy Oncology Group (RTOG) grading scale. The peak RTOG score was observed at Week 6, aligning with the cumulative radiation exposure. Maximum RTOG grades of 0, 1, and 2 were recorded in 6.7% (1/15), 40% (6/15), and 53.3% (8/11) of patients, respectively. By Week 8, transepidermal water loss was decreased to levels below baseline. The overall occurrence of RD in this study was notably lower than that previously documented, emphasizing the protective effects of ASC-EXO-containing cream against radiation-induced skin injury. Level of Evidence: 4 (Therapeutic).

Regenerative peptides are gaining attention in regenerative medicine and plastic surgery for their potential to enhance surgical recovery and tissue regeneration. This review synthesizes evidence on four key peptides-focusing on their potential applications in wound healing, scar optimization, and aesthetic plastic surgery. Preclinical studies show promise, safety profiles appear favorable, but rigorous clinical trials are lacking. The paucity of human studies highlights an urgent need for high-quality research. Plastic surgeons are well-positioned to lead investigations, integrating regenerative peptides into perioperative care and evaluating their ability to optimize outcomes in aesthetic procedures.

Epidemiologic and preclinical studies suggest a potential protective effect of breast implants against breast cancer, but underlying mechanisms remain unclear. The authors hypothesize that local inflammation after breast implant placement induces immunosurveillence. The authors of this study investigated whether serum from implant-exposed (IE) women reduced breast cancer cell viability compared with implant-naive (IN) women, and whether antibodies mediated this effect. Serum from IE and IN women with high or low antibody levels against estrogen receptor-alpha, mucin-1, or mammaglobin-A was incubated with cancer cell lines overexpressing each antigen (MCF7, T47D, and SKBR3, respectively). 3-(4,5-Dimethylthiazol-2-yl)-2,5-Diphenyltetrazolium Bromide (MTT) assays measured cell viability. Rescue experiments utilized recombinant antigen to neutralize antibodies. Thirty-six patients were enrolled, and 12 samples were used to assess viability for each cell line. Serum with high antibody concentrations reduced cell viability compared with serum with low antibody concentrations across all cell lines. IE serum reduced cell viability compared with IN serum across all cell lines. Rescue experiments reversed differences between high and low antibody serum, as well as between IE and IN serum, implicating antibodies as the mediators of reduced viability. Peripheral serum from IE women decreased breast cancer cell viability compared with IN women, even when matched for the same antibody levels. Antibody neutralization reversed differences. This suggests implant exposure altered antibody function or other serum components. These findings support the hypothesis that the inflammatory response to breast implants may increase breast cancer immunosurveillance, although significantly more work is needed to confirm a mechanism. Level of Evidence: 3 (Therapeutic).

Facial aging is characterized by soft tissue atrophy, subcutaneous fat redistribution, and dermal laxity, most pronounced in the lower face and submental region. High-intensity focused ultrasound (HIFU) is the benchmark noninvasive lifting modality, whereas microwave energy-based devices (MEBDs) have recently emerged, targeting adipose tissue and dermis. Although MEBD has been validated in body contouring, evidence for facial efficacy and safety remains limited. This study aimed to compare the efficacy and safety of MEBD and HIFU for facial rejuvenation in an East Asian population, emphasizing temporal improvement patterns, tolerability, and adverse events. The authors retrospectively analyzed 171 patients (MEBD: n = 89; HIFU: n = 82) treated at a single institution. MEBD used 7 and 3 mm handpieces for subcutaneous lipolysis and dermal tightening, guided by fat-compartment mapping. HIFU applied 600 shots at 3.0 and 4.5 mm depths targeting the dermis and superficial musculoaponeurotic system. Outcomes included blinded evaluator Global Aesthetic Improvement Scale (GAIS), Cutometer elasticity, Facial Aesthetic Surgery Outcome Questionnaire (FACE-Q) satisfaction, pain, and adverse events, assessed at baseline, 1 month, and 3 months. MEBD showed greater early improvements in GAIS, Cutometer parameters (R2, R5), and FACE-Q scores at 1 month, with lower pain (2.3 vs 4.7, P < .001) and fewer adverse events. By 3 months, HIFU surpassed MEBD in sustained GAIS, FACE-Q, and elasticity gains. Both modalities were safe, with only mild, transient effects. MEBD demonstrated rapid onset, superior tolerability, and lower complication rates, whereas HIFU provided stronger long-term lifting and elasticity improvements. These findings support complementary clinical roles and a compartment-based rationale for facial MEBD.