Daily Cosmetic Research Analysis

INTRODUCTION: The platysma muscle influences lower face and neck aesthetics and expression. Aging can lead to platysma prominence (PP), manifesting as visible neck bands that affect appearance and well-being. Although surgical treatments exist, they are invasive and carry notable risks. This systematic review and meta-analysis evaluated the efficacy and safety of onabotulinumtoxinA for treating PP. METHODS: We systematically searched the PubMed, Cochrane Library, and Embase databases through May 2025 for studies comparing onabotulinumtoxinA with placebo. Primary outcomes were ≥1-grade bilateral neck improvement on Participant Allergan Platysma Prominence Scale (P-APPS) and Clinician Allergan Platysma Prominence Scale (C-APPS) at days 14, 60, and 120. Secondary outcomes included patient satisfaction evaluated using the Appearance of Neck and Lower Face Questionnaire and safety indicators such as bruising, hemorrhage, post-dose swallowing or talking difficulties, and other adverse events. RESULTS: Three randomized controlled trials with 1003 intention-to-treat and 912 modified intention-to-treat patients were included. OnabotulinumtoxinA significantly improved P-APPS on days 14 (RR 3.64), 60 (RR 3.46), and 120 (RR 2.57), and C-APPS on days 14 (RR 4.03), 60 (RR 3.73), and 120 (RR 2.21), all p < 0.01. Patient satisfaction was also higher on days 14 (RR 5.71), 60 (RR 5.56), and 120 (RR 5.29), all p < 0.01. No significant differences were found in the safety outcomes between the onabotulinumtoxinA and placebo groups. CONCLUSION: OnabotulinumtoxinA provides significant and sustained improvements in aesthetic and psychosocial outcomes in patients with PP, without increased risk of adverse events. These findings support its role as a less invasive and effective alternative to surgery.

The use of fillers for cosmetic purposes has increased in recent years. Although generally considered safe, fillers are not exempt from complications, including ischemic events. Arterial ischemia is a rare but potentially serious complication that requires prompt recognition and management. Ultrasound-guided hyaluronidase injection is emerging as a precise and effective treatment approach. The authors present a pictorial case series of filler-induced arterial ischemia managed with ultrasound-guided hyaluronidase injections, and systematically review the literature on ultrasound findings, enzyme dosage, time to resolution, and overall effectiveness of this approach. They present 3 cases of filler-induced arterial ischemia in the frontal, nasal, and temporal regions with visible intravascular thrombosis managed with ultrasound-guided intravascular hyaluronidase injections. Additionally, the authors systematically reviewed literature from PubMed/Medline, Scopus, Embase, and Web of Science up to August 2024 to evaluate the effectiveness, dosage, and ultrasound techniques utilized in the ultrasound-guided treatment of vascular complications from hyaluronic acid fillers. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we screened 88 studies, finally including 9 studies after full-text evaluation. Data from these studies, alongside our 3 cases (totaling 83 cases), showed rapid resolution of symptoms and ultrasound abnormalities following ultrasound-guided hyaluronidase injections. Delayed hyaluronidase administration was associated with slower or incomplete recovery, highlighting the importance of early intervention. Ultrasound-guided hyaluronidase injections effectively resolve arterial ischemia caused by filler injections, with early intervention significantly enhancing outcomes. Prompt diagnosis and timely ultrasound-guided intervention should be emphasized in clinical practice. Further large-scale randomized studies are necessary to establish standardized treatment protocols for dosage and timing.

BACKGROUND: Obesity's impact on postoperative outcomes in abdominoplasty remains poorly defined despite its rising prevalence. This study evaluates the effect of obesity on 30-day postoperative complications to inform risk assessment and management. OBJECTIVES: Investigate the effect of obesity on 30-day postoperative complications following abdominoplasty. METHODS: We analyzed data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) for patients who underwent abdominoplasty between 2008 and 2022. Patients were categorized into obese (BMI ≥ 30 kg/m RESULTS: A total of 1,778 patients were included; 618 (34.8%) had obesity (mean BMI 35.2 ± 5.0 kg/m CONCLUSION: Obesity is an independent risk factor for complications following abdominoplasty. Optimized preoperative screening, potentially including DVT prophylaxis for patients with obesity, and tailored perioperative care are essential to improving outcomes in this population. Evidence-based guidelines are needed to enhance surgical safety for obese patients. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .