Aesthetics research

PMID: 42696333

J Drugs Dermatol. 2026 Sep 1;25(9):785-792. doi: 10.36849/JDD.9766.

ABSTRACT

BACKGROUND: Delayed complications associated with hyaluronic acid (HA) fillers are a concern in aesthetic medicine. However, clinical strategies for mitigation remain inconsistent, and guidelines often make recommendations that may lack the support of robust evidence. To address this gap, a multidisciplinary expert safety council convened to develop evidence-based recommendations aimed at reducing the delayed complication risk of soft-tissue augmentation with fillers, noting which recommendations are uncertain due to lack of evidence.

METHODS: A structured advisory board meeting was held with 8 United States-based experts in aesthetic injectables. Discussions were informed by a comprehensive literature review, pre-meeting surveys, and real-time polling, with consensus statements refined following the meeting.

RESULTS: The council reached full consensus on 8 key recommendations across 4 risk factor categories: patient history, product characteristics, procedural technique, and postprocedure care. A consistent theme across all categories was the lack of robust clinical evidence supporting many current guidelines, underscoring the need for more evidence-based recommendations.

CONCLUSION: This expert consensus highlights the need for evidence-informed approaches to HA filler safety. While definitive data remain limited, the panel offers a practical framework for minimizing delayed complications and identifying priorities for future research. .

PMID: 42620772

JPRAS Open. 2026 Jul 27;51:646-656. doi: 10.1016/j.jpra.2026.07.028. eCollection 2026 Sep.

ABSTRACT

The term "lift" is among the most frequently used outcomes, technique names, and product descriptors in the soft tissue filler literature, yet it has no consensus operational definition, no agreed measurement standard, and no validated threshold for clinical significance. We undertook a structured narrative critique of how "lift" is operationalised in the peer-reviewed filler literature for hyaluronic acid, calcium hydroxylapatite, poly-l-lactic acid, polycaprolactone, and hybrid products, and compared reported effect sizes against the documented accuracy of the measurement modalities used. The term "lift" is operationalised in multiple categorically distinct ways across this corpus. All published quantitative measurements reflect changes at the cutaneous surface rather than independent tracking of deeper structures. Reported mm-magnitude effects are often similar in magnitude to, and in some cases substantially exceeded by the standard deviation of the measurement and the documented accuracy of the imaging modality. Dose-response analyses, where performed, demonstrate a non-monotonic rather than dose-dependent relationship between injected volume and measured displacement. Studies comparing multiple rater groups suggest that less independent raters may report larger improvements. No reviewed study reports modality accuracy alongside effect size or pre-specifies a clinically meaningful threshold. These observations do not establish that fillers do not produce lift; they establish that the construct of filler-mediated lift has not yet been operationalised with the precision its claims now require. We propose a five-standard framework toward an operational definition.

PMID: 42610208

Aesthet Surg J. 2026 Aug 18:sjag165. doi: 10.1093/asj/sjag165. Online ahead of print.

ABSTRACT

BACKGROUND: Facial lifting with botulinum toxin in the lower face results from modulation of the balance between depressor and elevator muscles. Injection strategies typically describe dose and point distribution, although these parameters may reflect the extent of neuromuscular modulation across the treated area.

OBJECTIVES: To evaluate the effect of increasing treatment extent in lower face neuromodulator applications on tissue displacement, patient-reported outcomes, and tolerability.

METHODS: Eighty patients were allocated to four treatment groups differing in the number and distribution of lower-face injections targeting the platysma and depressor anguli oris muscles. Outcomes were assessed at 15, 30, and 90 days using 3D stereophotogrammetry, Global Aesthetic Improvement Scale (GAIS), and FACE-Q Satisfaction with Outcome and Adverse Effects modules. Associations with patient characteristics were also analyzed.

RESULTS: All treatments produced measurable lifting effects. Greater treatment extent was associated with increased tissue displacement at 15 days (p=0.004) and greater persistence of displacement over time. Patient-reported outcomes followed a similar pattern, peaking at 30 days and remaining higher in intermediate-to-high extent groups. Adverse effects decreased over time but were higher in the most extensive group at 90 days (p=0.006). Multivariable analysis demonstrated a positive association between number of injection points and tissue displacement (β=1.875; p=0.040), and a negative association with BMI (β=-4.361; p=0.022).

CONCLUSIONS: Lower-face neuromodulator treatments produce measurable lifting effects that scale with the extent of muscular coverage. Broader distribution enhances the magnitude and durability of tissue repositioning, although with a modest increase in perceived adverse effects. BMI may act as a response modifier.