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.

Introduction and importance: Morbid obesity can present with life-limiting panniculus morbidus, a severe excess of abdominal tissue. We describe the importance of a multidisciplinary, tailored surgical approach involving the resection of 30 kg of tissue to achieve both functional and psychological recovery, despite high perioperative risks. Case presentation: A 47-year-old man [body mass index (BMI) 61] presented with a pendulous pannus extending to the knees, leading to urinary and sexual dysfunction, recurrent skin infections, ulcerations, and inability to perform daily activities. He underwent an elective, two-stage panniculectomy. Intraoperatively, two supraumbilical hernias and aberrant lymphovascular clusters were identified. A total of 30 kg of tissue was removed. Closure employed progressive-tension sutures and negative-pressure dressings. Postoperatively, he developed a seroma and transient urinary incontinence, both managed conservatively. By 1 month, he had regained independence in activities of daily living and demonstrated marked psychological improvement. Clinical discussion: Resection of 30 kg of pannus qualifies as a “supersize” panniculectomy. Common complications – seromas and wound dehiscence – are more frequent in patients with a high BMI and comorbidities such as diabetes and smoking. However, with meticulous planning and technique, this case shows that even high-risk patients can achieve meaningful functional restoration and quality-of-life gains. Conclusion: Amid the global obesity epidemic, this report advocates for a flexible, function-driven surgical strategy in extreme cases typically deemed ineligible for intervention. When needed, panniculectomy can deliver substantial benefits that outweigh the inherent risks.

Peptides, particularly SA1-III decapeptide, play a key role in maintaining skin structure by inhibiting collagen degradation. The aim of this analysis was to investigate the combined effects of Definisse™ Revitalise Threads and Definisse [KP1]^® Redensifying Cream containing SA1-III for facial rejuvenation. Patients receiving Definisse™ Revitalise Threads were offered Definisse™ Redensifying Cream for one month. Outcomes—including efficacy, safety, and patient satisfaction—were assessed over six months using 3D imaging, clinical evaluation, and the FACE-Q™ questionnaire. Due to the sample size, data were summarised descriptively, with group comparisons using exact Mann–Whitney U tests and paired analyses using the Wilcoxon signed-rank test (p < 0.05). Nineteen individuals underwent treatment with Definisse™ Revitalise Threads (17 females and 2 males, aged 38–72 years); 10 patients used additional Definisse [KP1]^® Redensifying Cream while 9 did not. All patients reported significant improvements in skin satisfaction, cheek fullness, and perceived aging, based in FACE-Q^TM scores before and after treatment. Thread treatment visibly improved facial appearance, but the addition of the peptide-containing cream further enhanced skin quality. Indeed, greater improvements in skin satisfaction were reported by individuals using vs. not using Definisse [KP1]^® Redensifying Cream. No adverse events were reported, and the FACE-Q^TM Adverse Effects scale indicated only mild, transient effects. In this preliminary series with a six-month follow-up, the combination of Definisse Revitalise Threads and Definisse^® Redensifying Cream was well-tolerated and showed potential for enhancing facial rejuvenation. These preliminary findings suggest that peptide-based cosmeceuticals may complement aesthetic procedures and support skin health. These preliminary results will be used to generate hypotheses for larger studies with longer follow-up, which are needed to confirm these effects.

Introduction: The latissimus dorsi (LD) flap is a well-established option for breast reconstruction because of its reliable vascular pedicle and technical versatility. However, its main limitation is the relatively limited volume it provides, which has traditionally required the addition of a prosthetic implant to achieve adequate breast projection and symmetry. In selected patients with small- to moderate-sized breasts, the fat-augmented latissimus dorsi (FALD) flap may overcome this limitation by combining the LD flap with fat grafting. Presentation of case: We present the case of a patient who underwent a skin-sparing mastectomy with nipple–areolar complex excision. Immediate reconstruction was performed using an LD flap combined with intraoperative fat grafting. Fat harvested from the flanks was purified by decantation and injected during flap insetting into the mastectomy pocket. The postoperative course was uneventful, and the esthetic outcome was satisfactory, with good symmetry and volume preservation. Discussion: The FALD technique demonstrates significant reconstructive potential in selected cases, and performing lipofilling during the same operative session may also help reduce the need for staged revision procedures. This approach may also provide a secondary esthetic benefit by coupling breast reconstruction with body contouring. Despite its demonstrated advantages and favorable safety profile, FALD remains underutilized in current clinical practice. Conclusions: The FALD technique has proven to be a fully autologous, effective, and safe option for immediate breast reconstruction and deserves broader adoption, especially in cases in which implants or free flaps are not desirable or feasible.