Aesthetic surgery journal. Open forum最新文献

{"title":"Total Pedicle Preservation Mastopexy: Technique, Safety, and Long-term Results.","authors":"Radu Ionescu, Theodor Mareș, Daniel Dima, Mădălina Corina Totir, Cristian Radu Jecan","doi":"10.1093/asjof/ojag057","DOIUrl":"10.1093/asjof/ojag057","url":null,"abstract":"<p><strong>Background: </strong>Mastopexy aims to correct breast ptosis and restore contour and position, but existing techniques may compromise nipple-areola complex (NAC) vascularity, sensitivity, or lactation potential. Reported limitations include recurrent ptosis, bottoming out, and perfusion-related complications.</p><p><strong>Objectives: </strong>The aim of this study was to evaluate the long-term safety, stability, and effectiveness of total pedicle preservation mastopexy (TPPM) in women undergoing mastopexy.</p><p><strong>Methods: </strong>A prospective case series of 488 women (cup size A-D, grade I-II ptosis) underwent TPPM between 2012 and 2022, performed by a single surgeon. Patients were followed at 1, 6, 12, and 24 months. Primary outcomes included sternal notch-to-nipple (SN-N) distance, nipple-to-inframammary fold (N-IMF) distance, breast density (Shore O Durometer), and areolar diameter. Complications were recorded.</p><p><strong>Results: </strong>Mean SN-N distance decreased from 25.22 cm preoperatively to 20.65 cm at 24 months (<i>P</i> < .001). N-IMF distance increased modestly from 7.2 cm postoperatively to 8.1 cm at 24 months, corresponding to a 52.9% relapse of the initial correction with 47.1% of the initial correction maintained. Breast density increased from 7.6 to 8.8 Shore O units at 24 months (<i>P</i> < .001), remaining above baseline. Areolar diameter decreased from 64.2 mm preoperatively to 42.0 mm at 24 months. The overall complication rate was 2.5%. 12 events in 488 patients with no cases of NAC necrosis, hematoma, wound dehiscence, or infection.</p><p><strong>Conclusions: </strong>TPPM is a safe, reproducible mastopexy technique that achieves stable long-term results. It offers an effective alternative for patients seeking durable, natural outcomes without implants or major tissue excision.</p><p><strong>Level of evidence 4 therapeutic: </strong>For image description, please refer to the figure legend and surrounding text.</p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag057"},"PeriodicalIF":1.9,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13270333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148272949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Female Genital Cosmetic Surgery in Saudi Arabia: A Systematic Review of Awareness, Attitudes, Satisfaction, and Clinical Outcomes.","authors":"Dana Sawan, Deama Alghamdi","doi":"10.1093/asjof/ojag089","DOIUrl":"10.1093/asjof/ojag089","url":null,"abstract":"<p><p>Female genital cosmetic surgery (FGCS) has gained international attention because of changing beauty standards, social media influence, and greater access to surgical services. Although global evidence highlights rising awareness and uptake, data from Saudi Arabia remain scarce. This review followed PRISMA 2020 guidelines. A systematic search of PubMed, Google Scholar, the <i>Saudi Medical Journal</i> archive, and Index Medicus for the Eastern Mediterranean Region was conducted up to August 25, 2025. Eligible peer-reviewed English-language studies were those conducted in Saudi Arabia that examined awareness, attitudes, satisfaction, complications, or ethical perspectives. Methodological quality was appraised using Joanna Briggs Institute checklists. Of 1421 records identified, 5 studies met the inclusion criteria: 4 cross-sectional surveys and 1 case series. Awareness among Saudi women was moderate (∼50%), with 19% considering FGCS, whereas uptake remained low (7%-8%). Satisfaction among women who underwent surgery exceeded 85%. Physicians and medical students expressed cautious, ethically concerned attitudes, particularly toward hymenoplasty and vaginal rejuvenation. Reported complications were infrequent (<10%) and minor, although 1 case series described clitoral hood hair-thread tourniquet syndrome in pediatric patients. FGCS in Saudi Arabia is an emerging field. The findings highlight persistent ethical debates among physicians and underscore the urgent need for larger prospective studies and culturally sensitive national guidelines to regulate practice and align patient autonomy with societal values. This review aimed to systematically gather and summarize existing studies on FGCS in Saudi Arabia, with attention to awareness, attitudes, satisfaction, complications, and ethical concerns. <b>Level of Evidence</b>: 4 (Risk).</p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag089"},"PeriodicalIF":1.9,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13282939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148297469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Helium Plasma Radiofrequency for Aesthetic Subdermal Treatment: A Systematic Review and Meta-Analysis.","authors":"Sachin M Shridharani, Aris Sterodimas, Manya R Harsch, Kari A Larson","doi":"10.1093/asjof/ojag092","DOIUrl":"10.1093/asjof/ojag092","url":null,"abstract":"<p><p>Helium plasma radiofrequency (RF) technology (Renuvion, Apyx Medical, Clearwater, FL) has emerged as a minimally invasive option for treating skin laxity, either as a standalone procedure or as an adjunct to liposuction. While clinical adoption has expanded rapidly, the literature remains heterogeneous, with variable study designs and outcomes. To comprehensively evaluate the safety and performance of helium plasma RF for aesthetic subdermal applications through systematic review and meta-analysis. A systematic search was performed from initial device clearance through May 2025, following PRISMA guidelines. Eligible studies included randomized controlled trials, prospective cohorts, retrospective reviews, and case series with ≥10 patients undergoing aesthetic subdermal treatment with helium plasma RF. Safety outcomes were tabulated and weighted incidence rates calculated. Random-effects meta-analyses were performed to generate pooled estimates for performance endpoints, including patient satisfaction, investigator global aesthetic improvement scale (GAIS), patient GAIS, and independent photographic review scores. Thirty-four studies across 33 publications encompassing 3508 patients were included. Pooled complication rates were 5% for helium plasma RF-only, 8% for helium plasma RF + liposuction, and 15% for combination procedures involving multimodal excisional surgery; differences between groups were not statistically significant (<i>P</i> = .14). The pooled patient satisfaction rate was 92%. Meta-regression demonstrated higher satisfaction with longer follow-up durations (<i>P</i> = .003). This systematic review and meta-analysis suggest that helium plasma RF is associated with a favorable safety profile and high rates of patient satisfaction and aesthetic improvement in subdermal applications. <b>Level of Evidence</b>: 4 (Therapeutic) For image description, please refer to the figure legend and surrounding text.</p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag092"},"PeriodicalIF":1.9,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13293070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148334881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of Augmentation Mastopexy in a Teaching Environment: Complication Analysis.","authors":"Francesco Marena, Aline Carrer Bortolini, Alcemar Maia Souto, Farid Hakme, Tito Brambullo","doi":"10.1093/asjof/ojag090","DOIUrl":"10.1093/asjof/ojag090","url":null,"abstract":"<p><strong>Background: </strong>Breast hypoplasia and ptosis, whether congenital or acquired, may significantly affect body image and quality of life. Augmentation mastopexy is an effective corrective procedure but is technically demanding and associated with a recognized risk of complications, raising concerns regarding its role in surgical training.</p><p><strong>Objectives: </strong>The aim of this study was to evaluate the incidence and type of complications following augmentation mastopexy performed by plastic surgery residents under direct attending supervision and to assess the implications for training within an academic setting.</p><p><strong>Methods: </strong>A retrospective analysis was conducted of 289 consecutive augmentation mastopexy procedures performed between January 2020 and January 2024, with a minimum follow-up of 12 months. All procedures were performed by residents under the continuous supervision of experienced plastic surgeons. Data regarding patient characteristics, surgical technique, implant selection, and postoperative complications were collected and analyzed.</p><p><strong>Results: </strong>Forty-six complications were recorded, corresponding to an overall complication rate of 15.9%. Minor complications included suture dehiscence (4.84%), secondary ptosis (3.4%), asymmetry (3.11%), hematoma (1.3%), and seroma (1.3%). Major complications included capsular contracture (0.7%) and infection (1.0%). Reoperations were primarily required for major complications or patient-reported aesthetic dissatisfaction. Overall outcomes were comparable to those reported in the literature.</p><p><strong>Conclusions: </strong>Within a structured academic program with direct attending supervision, augmentation mastopexy can be safely performed by residents, achieving complication rates comparable to published data. These findings support the role of supervised augmentation mastopexy as a valuable component of plastic surgery training.</p><p><strong>Level of evidence 4 risk: </strong></p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag090"},"PeriodicalIF":1.9,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13267641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Cross-Sectional Analysis of Plastic Surgery With GLP-1-Related Content on TikTok.","authors":"Rohun Gupta, Sonia S Patel, Atharva M Bhagwat, Rushil Gupta, Thomas Y Xia, Herluf Lund, Sumesh Kaswan","doi":"10.1093/asjof/ojag094","DOIUrl":"10.1093/asjof/ojag094","url":null,"abstract":"<p><p>TikTok has risen to the forefront of social media platforms, becoming an increasingly popular source for health information dissemination. The utilization of glucagon-like-peptide-1 (GLP-1) agonists has resulted in a considerable increase in cosmetic plastic surgery interest. This study aims to analyze TikTok content related to medical weight loss medications and plastic surgery. TikTok was queried using several phrases to assess plastic surgery and weight loss related in November 2025. Video statistics and characteristics were reviewed and graded using the validated DISCERN tool for the top 50 videos from each search algorithm. <i>P</i>-values <.05 were noted to be statistically significant. A total of 101 videos met inclusion criteria with a total of 12,662,385 views, 318,749 likes, 1033 comments, and 54,245 shares. Most videos were produced by physicians (57.4%) followed by patients (23.8%). When stratified by content creator type, median DISCERN scores were similar across groups, although nonphysician healthcare providers had the numerically highest median score (<i>P</i> = .280; ε² = 0.011). Educational videos had statistically significantly greater DISCERN scores for items assessing videos' description of how treatments work, benefits of treatments, and outcomes if no treatment was used. This study found that social media platforms can help disseminate healthcare information. Although content varies across creator and video category subtypes, overall quality has improved and creators should look to provide qualified sources of healthcare information, foster an environment of shared decision-making, and for providers to discuss how GLP-1 medications and plastic surgery may affect quality of life.</p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag094"},"PeriodicalIF":1.9,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating Mastectomy Weight From Standard Breast Measurements, BMI, and Sister Bra Size: A Simple Clinical Formula.","authors":"Meghan N Miller, Eliana Jolkovsky, Derrick Lin, Ainaz Dory Barkhordarzadeh, Samantha Rabinovich, Stacy Piva, Nimmi S Kapoor, Amy M Kusske, Farnaz Haji, Ginger C Slack","doi":"10.1093/asjof/ojag035","DOIUrl":"10.1093/asjof/ojag035","url":null,"abstract":"<p><strong>Background: </strong>Accurately estimating breast weight is essential for surgical planning, particularly in mastectomy and immediate reconstruction. Current prediction methods are often impractical in routine clinical settings because of cost, complexity, or accessibility.</p><p><strong>Objectives: </strong>The authors sought to derive and validate a simple formula that can be utilized by both patients and providers to estimate mastectomy specimen weight using standard breast measurements, BMI, and sister bra size (SS).</p><p><strong>Methods: </strong>The authors performed a retrospective review of 177 mastectomy patients (333 breasts) from University of California, Los Angeles. Data collected included nipple-to-inframammary fold (N-IMF) distance, sternal notch-to-nipple (SN-N) distance, BMI, Regnault ptosis grade, and SS. Spearman and Pearson correlation tests were conducted to identify terms with strong predictive strength. A formula with 3 strong predictive terms was derived using linear regression.</p><p><strong>Results: </strong>The 3 terms included in the predictive equation were BMI × N-IMF (<i>ρ</i> = 0.857; <i>P</i> < .001), SS × N-IMF (<i>ρ</i> = 0.832; <i>P</i> < .001), and SN-N² (<i>ρ</i> = 0.72; <i>P</i> < .001). The final formula, which was Mastectomy specimen weight (g) = 1.32 × (BMI × N-IMF) + 2.0 × (SS × N-IMF) + 0.13 × (SN-N)² - 32 demonstrated strong predictive performance (<i>R</i> ² = 0.783; root mean square error = ±119 g).</p><p><strong>Conclusions: </strong>The authors present a simple formula that can accurately estimate mastectomy specimen weight using BMI, N-IMF distance, SN-N distance, and SS.</p><p><strong>Level of evidence 4 therapeutic: </strong>For image description, please refer to the figure legend and surrounding text.</p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag035"},"PeriodicalIF":1.9,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13188843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147990156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determining the Position, Morphology, and Location of the Depressor Anguli Muscle Through Ultrasound in the Caucasian Population.","authors":"Simone Ugo Urso, Elena Calabria, Antonella Franceschelli, Bianca Genovese, Paola Molinari, Michela Piludu, Martina Zuccaro, Luca Bastiani, Giovanni Mosti","doi":"10.1093/asjof/ojag091","DOIUrl":"10.1093/asjof/ojag091","url":null,"abstract":"<p><strong>Background: </strong>The depressor anguli oris (DAO) muscle plays a key role in expressing sadness by lowering the oral commissures. Botulinum toxin (BT) is frequently used to weaken DAO hyperactivity, but results remain inconsistent because of reliance on cadaveric studies and surface landmarks, often derived from Asian populations. Ethnic anatomical variability may compromise injection accuracy.</p><p><strong>Objectives: </strong>The aim of this study was to evaluate DAO morphology in Caucasian patients using high-frequency ultrasound.</p><p><strong>Methods: </strong>A total of 290 Caucasian patients seeking DAO treatment with BT were assessed. Exclusion criteria were neuromuscular disease or previous BT in the area. Ultrasound evaluated the DAO position relative to the mid-pupillary line, depth from the skin, and overlap with adjacent muscles.</p><p><strong>Results: </strong>DAO localization showed significant variability: 20.2% were aligned with the classical mid-pupillary landmark and 79.8% exhibited lateral displacement (2-5 mm). Mean DAO depth was 3.1 mm, greater in overweight/obese patients (<i>P</i> < .001). Overlap with the depressor labii inferioris occurred in 12%.</p><p><strong>Conclusions: </strong>DAO topography in Caucasians differs significantly from that reported in standard references. Blind injections may reduce the treatment efficacy and increase the side-effect rate. High-frequency ultrasound enables precise DAO mapping, individualized injection planning, and improved treatment predictability. Preinjection ultrasound should be considered for safe and effective DAO neuromodulation.</p><p><strong>Level of evidence 3 diagnostic: </strong></p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag091"},"PeriodicalIF":1.9,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posting With Purpose: A Strategic Instagram Workflow for Plastic Surgeons.","authors":"Nada E Botros, Nicholas Mosca, Sakar Gupta, Ferris Zeitouni, Peter Wirth, Venkat K Rao","doi":"10.1093/asjof/ojag095","DOIUrl":"10.1093/asjof/ojag095","url":null,"abstract":"<p><p>Instagram (Meta, Menlo Park, CA) has become an important tool for patient education, practice marketing, and professional branding within plastic surgery. As public interest in aesthetic surgery continues to rise alongside increasing surgeon engagement with visually driven social media, there is a growing need for a practical, ethically grounded framework to guide professional use of Instagram. This article provides a structured, evidence-informed approach to the effective and responsible use of Instagram by plastic surgeons. Key topics discussed include profile optimization, content development strategy, performance analytics, and mitigation of legal and ethical risk. Specific recommendations are provided for educational, marketing, and personal content, with emphasis on maintaining professionalism, transparency, and patient confidentiality. Considerations regarding content timing and posting frequency to optimize audience engagement are also reviewed. When applied strategically, Instagram can serve as a powerful tool for patient education, trust building, and practice growth, while simultaneously facilitating professional networking and knowledge dissemination within the field of plastic surgery.</p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag095"},"PeriodicalIF":1.9,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13274463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Breast Implant Size Larger Than Mastectomy Specimen Size Increase the Risk of Flap Necrosis?","authors":"Lisa B Cassileth, Kelly Killeen, Amy York, Dorian Rosen","doi":"10.1093/asjof/ojag063","DOIUrl":"10.1093/asjof/ojag063","url":null,"abstract":"<p><strong>Background: </strong>Mastectomy skin flap necrosis (MSFN) is a critical postoperation complication in postmastectomy breast reconstruction. High replacement tissue expander fill volume and large mastectomy specimen size are commonly assumed to increase MSFN risk. Thus, a common recommendation in the practicing surgeon's office is not to increase breast volume during reconstruction. However, there is minimal literature on the question of whether postsurgical large or larger breast size is a risk factor for MSFN.</p><p><strong>Objectives: </strong>This study asked whether risks of MSFN and other complications were increased when an implant larger than the size of the mastectomy specimen was placed during direct-to-implant (DTI) reconstruction for nipple-sparing mastectomy (NSM).</p><p><strong>Methods: </strong>A 9-year retrospective review of immediate DTI breast reconstruction by 2 surgeons at a private clinic was conducted encompassing a total of 499 breasts in 270 consecutive adult female patients. Compared were patients with breasts that had implants placed greater in size in cubic centimeters than the weight of mastectomy specimen in grams (the upsize group, n = 361) vs those that had smaller implants placed (the downsize group, n = 138).</p><p><strong>Results: </strong>MSFN was nonsignificantly lower in the upsize group compared to the downsize group (3.59% vs 4.35%, <i>P</i> = .6966). When secondary outcomes differed significantly, complications were higher in the downsize group. BMI, but not size difference between specimen and implant, significantly predicted MSFN in logistic regression modeling.</p><p><strong>Conclusions: </strong>Increasing breast size was not associated with increased risk of MSFN after NSM with DTI reconstruction.</p><p><strong>Level of evidence: </strong>3 (Therapeutic) For image description, please refer to the figure legend and surrounding text.</p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag063"},"PeriodicalIF":1.9,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13213588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148058476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longevity Aesthetics: A Conceptual Framework for Integrating Pro-Aging Medicine Into Surgical and Nonsurgical Practice.","authors":"Diala Haykal, Foad Nahai","doi":"10.1093/asjof/ojag088","DOIUrl":"10.1093/asjof/ojag088","url":null,"abstract":"<p><p>The prevailing paradigm in aesthetic medicine is the \"antiaging\" model, which focuses on correcting and/or reversing visible signs of aging. However, contemporary geroscience reconceptualizes aging as a malleable biological process driven by defined hallmarks, offering an opportunity to align aesthetic practice with the fundamental aging biology. This article explores the concept of \"pro-aging\" or \"longevity aesthetics,\" a framework that prioritizes tissue function, resilience, and biological integrity alongside phenotypic improvement. The skin is presented as an accessible model organ that reflects key hallmarks of aging and their clinical manifestations. Although conventional aesthetic interventions effectively address structural changes, they often do not target upstream biological drivers of tissue aging. Within this framework, certain surgical and nonsurgical modalities may theoretically support tissue resilience through modulation of inflammation, collagen remodeling, and microvascular health. Importantly, some of these strategies, such as biostimulatory injectables including calcium hydroxylapatite and poly-L-lactic acid, as well as combination treatment approaches, are already integrated into clinical practice, whereas others remain in the translational or research domain. Emerging concepts such as multi-omics, defined as the integration of genomics, transcriptomics, proteomics, metabolomics, and epigenomics, may further enable personalized and predictive approaches in the future. Longevity aesthetics, therefore, represents a conceptual evolution from correction to functional preservation. However, direct clinical evidence supporting its biological impact remains limited, and these concepts should currently be interpreted as hypothesis driven. Advancing this framework will require prospective studies integrating biomarkers with long-term clinical outcomes. Ultimately, this approach positions aesthetic medicine to contribute to translational geroscience, provided innovation is guided by methodological rigor and ethical transparency. Level of Evidence: 5 (Therapeutic).</p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag088"},"PeriodicalIF":1.9,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}