Nanofat is a relatively novel technique in fat grafting that has gained significant interest in the fields of regenerative medicine, aesthetic and translational research. It involves the extraction of autologous fat from a patient, which is then transformed into “nanofat”, consisting of small fat particles with a diameter of less than 0.1 mm and containing high concentrations of stem cells and growth factors. This article focuses on the use of nanofat in facial rejuvenation and its potential for lipomodelling. Fat tissue is a “stem cell depot” and nanofat contains many stem cells that can differentiate into various cell types. The Lipogem technology, developed in 2013, enables the isolation of nanofat with an intact perivascular structure, utilizing the high concentration of mesenchymal stromal cells near the pericytes of the adipose vascular system. Nowadays nanofat is used primarily for cosmetic purposes particularly in rejuvenating and improving the appearance of the skin, especially the face. Indeed, it has wide applicability; it can be used to treat fine lines, wrinkles, acne scars, sun-damaged skin, scar repair, and as an alopecia treatment. However, further studies are needed to assess the long-term efficacy and safety of this technique. In conclusion, nanofat is a safe and minimally invasive option for tissue regeneration with considerable therapeutic potential. This study reviews the application and effects of nanofat in regenerative medicine and facial cosmetic surgery.

Background: Facial aging is a multifaceted process involving structural changes in deeper tissues alongside skin alterations. Dermal fillers, including hyaluronic acid and non-hyaluronic acid variants, have emerged as key tools in addressing these changes, offering safe, effective, and minimally invasive solutions. Polycaprolactone (PCL) is a biocompatible, biodegradable polymer with remarkable collagen-stimulating properties. Methods: This pilot study explored the efficacy and safety of liquid PCL-based filler in rejuvenating the middle third of the face in 30 patients during a 6-month period, who underwent 2 treatments with PCL filler using a 25G cannula. Results: The results demonstrate significant improvements in skin quality and volume, with high patient satisfaction rates. Although adverse events were mild and transient, careful injection techniques are recommended to mitigate risks. The gradual dissipation of the PCL-based filler induced the formation of new collagen, ensuring a prolonged volumizing effect in the middle third of the face. Conclusions: The ability of PCL to stimulate collagen production offers promising prospects for long-term facial rejuvenation, underscoring its importance in modern aesthetic medicine.

Background: Poly-L-lactic acid (PLLA) is a biostimulatory injectable that restores midfacial volume through collagen neogenesis rather than gel-based filling. Controlled clinical evidence directly quantifying PLLA's volumetric efficacy remains limited. Objectives: To evaluate the efficacy, safety, and patient-reported outcomes of a Norberg Medical PLLA formulation for midface rejuvenation in a prospective, evaluator-blinded, split-face controlled study. Participants were enrolled between July 2024 and September 2024, with follow-up completed in September 2025. Methods: Ninety-five patients underwent three standardized PLLA sessions on one hemiface and saline placebo on the contralateral side. Each vial contained 150 mg PLLA in spherical microparticles, reconstituted with 5 mL sterile water without lidocaine. Assessments included Wrinkle Severity Rating Scale (WSRS), Vectra H1 3D volumetry (malar, zygomatic, mandibular), FACE-Q, and Global Aesthetic Improvement Scale (GAIS). Two blinded evaluators rated WSRS. Statistical analysis included paired testing, responder rates (≥1-grade WSRS improvement), and inter-rater reliability (ICC). Results: At 12 months, PLLA-treated sides showed significant WSRS reduction vs baseline and saline control (Δ = −0.68, P < .001). 3D analysis confirmed sustained volumetric enhancement across all midface subunits. Inter-rater reliability was excellent (ICC = 0.91), and 82.1% achieved ≥1-grade WSRS improvement. Patient satisfaction remained high, mirroring objective findings. Adverse events were mild and transient, with no granulomas, nodules, or vascular events recorded. Conclusions: Controlled split-face evaluation demonstrated that standardized PLLA treatment yields measurable, long-lasting midfacial volume restoration with excellent safety and high patient satisfaction. No granulomas or delayed-onset nodules were observed in this 12-month, 95-patient cohort, supporting a favorable safety profile for this PLLA formulation under these study conditions. Level of Evidence: 2 (Therapeutic): For image description, please refer to the figure legend and surrounding text.

Background: Patient care following botulinum toxin injections has long been guided by anecdotal instructions, often based on theoretical considerations. This study evaluates the necessity of extended post-treatment instructions by analyzing outcomes and satisfaction in patients who followed only a 10 min precaution protocol. Materials and Methods: A retrospective, multicentric study was conducted across six Italian centers, analyzing 5014 patients treated with botulinum toxin for upper facial wrinkles between 2015 and 2020. Outcomes included adverse effects—particularly upper eyelid ptosis—and patient satisfaction. Follow-up was performed at two weeks. Results: No cases of upper eyelid ptosis were observed. Among 4000 patients who attended follow-up, adverse effects occurred in only 5.99%, notably lower than rates reported in the literature. Of the 2010 patients who completed the satisfaction questionnaire, 90% reported being very satisfied. These findings support the safety of limiting post-treatment instructions to 10 min. Conclusions: Our findings indicate that omitting extended post-injection instructions does not negatively impact patient satisfaction or complication rates. Given the toxin’s rapid internalization and localized effect, extended behavioral restrictions may be redundant. However, the absence of a control group and lack of statistical analyses limit the strength of these conclusions. In addition, this is a short-term study. Future prospective, randomized trials are needed to develop evidence-based post-care protocols to optimize esthetic outcomes, patient safety, and long-term efficacy.