Reframing Hyaluronidase in Aesthetic Medicine: From “Dissolving Filler” to “Modifying Filler”

The use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for inducing weight loss has increased in recent years, resulting in a parallel reduction in demand for bariatric surgery. Consequently, the need for patients to undergo aesthetic procedures, including aesthetic breast surgery, following successful GLP-1 RA–induced weight loss is expected to increase while the demand created by postsurgical weight loss is expected to decrease. The objective of this narrative review is to examine the literature on the use of GLP-1 RAs and other mechanisms used for medical weight loss to assist plastic surgeons in achieving optimal aesthetic outcomes with breast surgery after weight loss occurs.

Melasma is a chronic, relapsing hyperpigmentation disorder that is difficult to treat, particularly in Fitzpatrick skin types III-V, where energy-based devices frequently induce postinflammatory hyperpigmentation (PIH). Radiofrequency microneedling (RFMN) has emerged as a promising alternative because it targets dermal pathology while minimizing epidermal injury.

Collagenase clostridium histolyticum-aaes (CCH-aaes) is FDA-approved for cellulite treatment but was withdrawn because of high bruising incidence. Histological effects of CCH-aaes in humans remain poorly characterized. The aim of the study was to evaluate histopathologic changes in human subcutaneous tissue following CCH-aaes injection and compare injection techniques to identify strategies that reduce bruising.

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.

Ptosis, the drooping of the upper eyelid caused by levator palpebrae superioris dysfunction, can impair vision and quality of life.