Artigos Científicos

Abdominal contouring has progressively evolved from isolated fat reduction techniques toward multimodal approaches that simultaneously address adipose tissue, muscular definition, and body composition. This retrospective case series describes preliminary clinical observations in five physically active patients with persistent localized abdominal adiposity despite regular resistance training, adherence to a low-carbohydrate diet, and protein supplementation. All patients underwent a standardized six-month multimodal protocol consisting of two sequential phases. The first phase combined injectable lipolysis using sodium deoxycholate, pentoxifylline, and L-carnitine with ultrasonic cavitation (Mesolipo). The second phase (Abdomen Definition) comprised targeted subcutaneous injections intended to enhance abdominal grooves, intramuscular metabolic support of the rectus abdominis, and neuromuscular electrical stimulation using Russian current. Treatment outcomes were assessed through standardized clinical photography, anthropometric measurements, and multifrequency bioimpedance analysis before and after completion of the protocol. Descriptive pre- and post-treatment comparisons showed reductions in median abdominal circumference from 94 to 88 cm, body fat percentage from 13.7% to 10.3%, fat mass from 11.3 to 8.7 kg, and abdominal skinfold thickness from 22 to 16 mm. Skeletal muscle mass was preserved or increased in most patients, while standardized photographs showed visually apparent changes in abdominal contour and definition, including greater visibility of the rectus abdominis, linea alba, and semilunar lines. In several cases, changes in body composition were observed despite minimal variation or slight increases in total body weight, a pattern compatible with body recomposition rather than weight loss alone. Given the retrospective, uncontrolled design, the small sample size, and the simultaneous use of multiple interventions, these observations cannot establish treatment efficacy or determine the relative contribution of individual protocol components, resistance training, or nutritional habits. Nevertheless, the findings provide preliminary, descriptive, and hypothesisgenerating observations regarding the feasibility of a multimodal approach to abdominal contouring. Prospective controlled studies with larger samples are needed to evaluate efficacy and determine the contribution of individual therapeutic components.

The number of men undergoing aesthetic procedures has increased substantially worldwide, highlighting the need to understand the characteristics of those who undergo them. However, evidence focusing on male populations remains limited. This study aimed to describe the sociodemographic characteristics and FACE-Q scale patient-reported outcomes of men with and without previous aesthetic procedures, and to explore which characteristics were associated with having undergone them. Methods: This cross-sectional online survey included 231 men aged 18–65 years. Participants were allocated into two groups according to previous experience with aesthetic procedures: yes to aesthetic procedures (YAP; n = 93) and no to aesthetic procedures (NAP; n = 138). Sociodemographic variables and six independently functioning FACE-Q scales were collected: aging appraisal, appearance-related psychosocial distress, satisfaction with facial appearance, psychological function, social function, and satisfaction with lower face and jawline. Univariate between-group comparisons and exploratory multivariate analyses were performed. Results: Participants in the YAP group were more frequently from Brazil, aged ≥ 31 years, and in the higher-income group (p < 0.05). They reported lower Aging Appraisal scores, (trimmed mean difference −15.8; 95% CI −21.6 to −9.9), greater appearance-related psychosocial distress (+13.1; 95% CI 6.4–19.7), and lower satisfaction with facial appearance (− 8.6), psychological function (−8.6), and satisfaction with the lower face and jawline (−11.4). Multivariate analysis showed substantial overlap between groups (R2Y = 0.292; Q2 = 0.256). In the exploratory logistic regression, Brazilian participants (OR 0.29; 95% CI 0.14–0.57), age ≥ 31 years (OR 2.35; 95% CI 1.08–5.13), and higher income (OR 2.90; 95% CI 1.27–6.61) were associated with previous aesthetic procedures, whereas no FACE-Q scale was independently associated with the outcome. Conclusions: Men undergoing previous aesthetic procedures did not demonstrate a clearly psychosocial profile compared with the general male population. However, age, country, and income, but not any FACE-Q, were independently associated with undergoing these procedures.

Botulinum toxin type A is widely used in aesthetic and therapeutic medicine and is considered safe. Nonetheless, rare adverse reactions can occur, even in patients with no previous allergic history. The authors report the case of a 50-year-old woman who developed a localized inflammatory reaction characterized by erythema, edema, vesicles, burning, and pruritus following injections in the upper face. A reactivity test with another formulation in the subcutaneous tissue of the arm produced an even more severe response, suggesting greater immune reactivity in subcutaneous tissue compared with muscle. Considering the known differences among commercial formulations, including accessory proteins and stabilizers, the test excluded the hypothesis of an allergy specific to a single brand. Standard therapies with corticosteroids and antibiotics failed to produce improvement, whereas ozone therapy led to significant recovery. This case emphasizes the importance of individualized follow-up and highlights the need for further studies to elucidate the immunopathological mechanisms underlying such rare hypersensitivity reactions.

Poly-L-lactic acid (PLLA) is widely used in aesthetic medicine for its ability to induce neocollagenesis and restore facial volume. Although considered a predictable procedure, technical variability during injection, particularly inconsistent volumetric planning and heterogeneous product distribution, may result in nodules or surface irregularities. This technical report introduces and describes a reusable silicone template designed to assist in volumetric planning for PLLA-SCA (Sculptra; Uppsala, Sweden: Galderma) injections. The BioMold (São Paulo, Brazil: TAB Instrumentos Cirúrgicos Ltd) was developed to support clinicians in performing more structured treatment mapping compared with conventional freehand marking approaches. Rather than relying exclusively on linear retroinjection patterns, the device proposes a spatially organized planning strategy based on predefined geometric sectors. By incorporating commonly adopted reconstitution parameters (10 mL total volume: 8 mL sterile water + 2 mL lidocaine) and the frequently used dose reference of approximately 0.2 mL/cm², the template is intended to help estimate treatment area and injection volume per vector. The device is available in three base sizes (3 cm, 4 cm, and 5 cm), corresponding to volumetric areas of approximately 7.2-12 cm² and suggested injection volumes of 1.4-2.4 mL. Its trapezoidal geometry and integrated slots allow clinicians to transfer retroinjection pathways directly to the skin, which may support more uniform product distribution compared with conceptual mapping techniques. BioMold represents a standardized physical mapping alternative to subjective freehand planning in PLLA procedures. While clinical performance and outcome impact require future investigation, the device is intended to improve planning reproducibility and procedural organization in biostimulatory treatments.

Nonsurgical rhinoplasty with hyaluronic acid (HA) is minimally invasive but may result in severe vascular complications such as ischemia and necrosis. This case report describes a 30-year-old female patient who developed ischemia and early necrosis of the nasal tip after HA injection. Treatment was initiated approximately 72 hours after the injection, and management included multipoint hyaluronidase, massage and warm compresses, low-level red laser therapy, systemic antibiotic and corticosteroid administration, in addition to hyperbaric oxygen therapy and photodynamic therapy. Regression of ischemia was observed on the first day after treatment initiation, and complete re-epithelialization occurred within 26 days. Early diagnosis and multimodal management centered on hyaluronidase favored ischemia reversal and wound healing, minimizing sequelae.

Regeneration has emerged as a key concept in aesthetic medicine as the field evolves from predominantly volumetric correction toward biologically oriented strategies aimed at improving tissue quality, function, and long-term structural integrity. However, the widespread use of the term “regenerative” has often been used without biological precision, leading to conceptual overlap with repair, remodeling, and biostimulation. A critical evaluation of the biological basis and clinical evidence supporting regenerative claims is needed.