We present our experience of using the UROLASE+ surgical system, based on thulium laser technology, in the context of plastic surgery. Our work with the thulium fiber laser for soft tissue dissection in vitro, ex vivo, and in vivo is described, and the positive outcomes of using the thulium fiber laser, which has not previously been employed in aesthetic surgery of the face and body, are demonstrated in this study. Integration of the thulium fiber laser may enhance safety and facilitate tissue dissection through more precise interventions, reduced blood loss, and improved clinical outcomes. This is particularly relevant for patients who have undergone cosmetic procedures leading to fibrotic changes in soft tissues, which complicate inter-tissue dissection when using traditional methods.

The pursuit of youth and attractiveness is a fundamental desire in contemporary society. For many individuals, the appearance of visible signs of aging, such as skin laxity, gravitational changes in facial and neck soft tissues, and loss of harmonious proportions, can be psychologically distressing. The choice of effective methods for addressing these changes depends on their specific characteristics, the patient’s anatomical features, and the type of facial aging. The introduction of 3D imaging to determine the hyoid bone level, the volume of soft tissue structures in the cervico-mental area, ptosis of subplatysmal structures, and the volume of submandibular glands, in addition to ultrasound study of the submental projection at the preoperative stage, are key for making the best decisions regarding preoperative planning. This case report aims to illustrate how modern imaging techniques are a fundamental part of the preoperative assessment of the mid and lower third of the face to ensure the most favorable aesthetic outcomes for each patient.

The quest for surgical advancements regarding the enhancement of the submental and cervicofacial regions has witnessed a remarkable upsurge in recent years. Informed patients are actively seeking sophisticated plastic surgery techniques to achieve comprehensive rejuvenation in these specific areas. Common complaints expressed by these patients include sagging of the jawline, the emergence of deep perioral wrinkles, and the formation of “marionette lines” within the lower third of the face. Furthermore, the manifestation of age-related signs, including neck laxity, submental adipose accumulation, “witch’s chin” deformity, and weakened platysma musculature, are common within this anatomical region. This literature review aims to summarize recent technical improvements, historical evolution, indications, postoperative care, and challenges for facial rejuvenation of the lower third of the face and neck. The application of minimally invasive procedures as part of a comprehensive approach for an aging face will also be discussed. In this article, an extensive search of the available literature was conducted using leading databases, including PubMed and MEDLINE, with the keywords “neck lift”, “platysmaplasty”, “facial rejuvenation”, “medial platysmaplasty”, “lateral platysmaplasty”, “neck rejuvenation”, and “cervicofacial rejuvenation”.

Objective: In this study, we analyzed the existing chin augmentation methods and evaluated the effectiveness of using a subplatysmal fat autograft for augmenting insufficient chin projection. Materials and Methods: From January 2017 to December 2023, we studied 170 patients at the Department of Plastic Surgery, Sechenov First Moscow State Medical University, who presented with insufficient chin projection, localized fat deposits in the cervico-mental area, and age-related changes in the lower third of the face. The patients were divided into two groups: Group 1 (n = 93) consisted of patients who underwent chin augmentation using implants (Silastic, Medpor); Group 2 (n = 77) included patients who underwent medial platysmaplasty and chin augmentation using a fat autograft (subplatysmal autograft). Results: Chin augmentation was performed on all the patients with varying degrees of insufficient chin projection. The mean age was 36.5 ± 2 years. The average follow-up period was 18.9 months (range: 2–45 months). For chin augmentation using implants (Silastic, Medpor), +chin projection increases were observed as follows: 1.1–1.2 cm at 3 months, 0.9–2.3 cm at 6 months, and 0.8–1.7 cm at 12 months. The complications in this group included inflammatory processes in 7 (8%) patients, hematomas in 6 (6%) patients, and contour asymmetry in 13 (14%) patients. In the group that underwent chin augmentation with a subplatysmal fat autograft, the chin projection increased by 0.8–1.2 cm at 3 months, 0.7–1.3 cm at 6 months, and 0.6–1.9 cm at 12 months. The mean age was 38.3 ± 7 years, with an average follow-up of 18.3 months (range: 2–43 months). No infectious–inflammatory complications were observed. Aesthetic complications were noted in 14 (18%) patients. Conclusions: Among the existing methods for chin augmentation, many still consider osseous genioplasty to give more predictable results. However, its traumatic nature and lengthy rehabilitation period prompt surgeons to seek effective yet less invasive alternatives. When selecting a minimally invasive method for chin augmentation, preference is given to fat injections (lipofilling) and intraoperative use of autologous fat grafts. Augmentation using subplatysmal autologous fat grafts is a minimally invasive, safe, predictable, and long-lasting method for chin correction.

Introduction: Gold threads became widely used in esthetic surgery in the early 1990s. Produced in Spain, these threads consisted of a gold thread (5/0) with a diameter of 0.1 mm, composed of 99.99% pure gold, which was combined with a polyglycolic thread. Since then, discussions about their effectiveness have continued, which is the focus of our study. Patients and Methods: Gold thread implantation was performed on 11,062 patients in four clinics in Moscow over the course of 28 years. This study used a comparative analysis of photo collages created for the visual representation of data and changes before and after the procedure, as well as patient satisfaction assessments using the Patient Satisfaction Scale (PSS). We examined the results of 492 patients who underwent gold thread implantation in the face between 1996 and 2024. Of these patients, 86% were women aged 30 to 60 years, 11% were women aged 20 to 30 years, and 3% were men aged 25 to 60 years. Results: One year after thread implantation, the PSS assessment showed a 91% success rate with minimal complications. Patient satisfaction was high, with an average score of 4.8 out of 5 after one month, 4.7 after six months, and 4.6 after one-year post-procedure. Discussion: Gold thread implantation is a minimally invasive procedure that has demonstrated a high level of safety, making it an effective option for facial rejuvenation. Histological studies have shown that gold threads stimulate the production of collagen and elastin and activate angiogenesis, thereby improving skin nourishment and hydration, as well as enhancing the skin tone, elasticity, and turgor. To improve the qualitative characteristics of the skin, it is necessary to work in the subcutaneous layer. Conclusions: Gold thread implantation strengthens the connective tissue framework at the implantation site, thus improving skin nourishment and hydration. Gold threads provide a long-term rejuvenating effect, slowing the ptosis of the soft tissue of the face and neck. Gold thread implantation does not interfere with tissue dissection during surgical interventions or the performance of any cosmetic procedures, including hardware-based treatments.

Age-related changes to the chin region and neck are among the most common reasons for consulting a plastic surgeon, and the outcome of rejuvenation surgery largely depends on the accuracy of preoperative planning. Digital imaging methods allow for an objective assessment of individual anatomical features, personalization of the surgical strategy, and improved predictability of the result. In this narrative review, based on a structured, PRISMA-informed search (PubMed, Scopus, Google Scholar, and eLibrary; 65 publications included), we systematize contemporary digital and radiological imaging methods for the chin region and neck—two-dimensional photography, three-dimensional photogrammetry, computed tomography and magnetic resonance imaging, cone-beam computed tomography (CBCT), CAD/CAM technologies, virtual and mixed reality, and artificial intelligence tools—and assess their diagnostic value for planning rejuvenation surgery. Available preliminary, predominantly single-centre evidence suggests that CBCT performed in the upright patient position may be the most informative modality for this task: by capturing bony landmarks together with the position and outer contours of the relevant soft-tissue structures under gravitational load, it supports an objective assessment of the contribution of individual structures to age-related deformities and well-founded, individualized surgical planning. Its intrinsic soft-tissue contrast resolution is nevertheless limited compared with MRI. The integration of digital and radiological imaging methods is a vital part of modern planning of aesthetic surgery for the chin region and neck.