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Page 2 of 8 Dobke et al. Plast Aesthet Res 2020;7:1 I http://dx.doi.org/10.20517/2347-9264.2019.65

INTRODUCTION
Many technologies are currently available for developing effective cosmeceuticals with the goals of facial
rejuvenation through procedures with varying levels of “invasiveness”. These include non-invasive and
invasive (requiring anesthesia) modalities; multi-platform devices for tissue contouring, comprising skin
tightening modalities, fat reduction, and/or volumization procedures; genomic/molecular-level intervention
[1,2]
to slow down the aging process; and nano and regenerative technologies . Molecular concepts in the field
of cosmetology indicate that even seemingly distant human body components and parameters such as gut
[3]
microbiome and skin quality are related . Furthermore, nanorobots and/or specific nanocosmeceuticals
may form micellar nanostructures capable of carrying both hydrophilic and hydrophobic agents with rapid
uptake into cells. These agents can be, for example, antibiotics to treat acne or agents targeting interventions
on the molecular level such as prevention of telomere attrition, thus protecting skin DNA and structural
[1,4]
proteins from aging and loss of native growth factors .
The goal of this review is to present and discuss current and potential future trends in facial and neck
rejuvenation. In doing so, this review links current technologies with what may be considered somewhat
futuristic approaches and perspectives. The authors felt that it was important to survey practicing board-
certified plastic surgeons to determine how they felt about the significance of emerging trends (not only
nano and regenerative), their expected prevalence and applicability to the areas of facial and neck aesthetic
surgery practices in the coming decade, and to determine whether the perspective of scientific researchers
is congruent with non-academic practitioners. Furthermore, the authors sought to potentially determine
educational priorities among plastic surgeons.

From this analysis, the question that arises is whether the familiarity with nano and regenerative concepts
is useful to a practitioner. The answer should be “yes”, as trends clearly indicate that many procedures may
be combined and include approaches which may appear to be distant and esoteric today, but are clearly
going to be a large part of the daily practice of facial rejuvenation in the near future. Lastly, the question
arises as to why to review nanoscience and regenerative technologies in one article. The simple reason is
that it appears that both are tightly intermingled and one of the primary goals of this review is to point out
and comment on these links .
[2,5]

DEFINITIONS
For the purpose of this review, the following definition of nanotechnology was applied: nanoscience is the
area of science, including healthcare, that deals with developing and producing extremely small devices and
molecules. Nanoscale materials are classified in the range of 10 m (there are 25,400,000 nanometers in an
−9
[6]
inch) .
Regeneration is defined as the process of renewal, restoration, and regrowth of damaged tissue or tissue
replaced in the process of natural fluctuation or events (e.g., hair). Regeneration can be either complete,
where the new tissue is the same as the tissue replaced, or incomplete, where different qualities of tissue
replace the original (e.g., scar formation). Aspects of the regenerative processes for nerves, bones, and
skin were traditionally emphasized and studied in plastic surgery. Advances in molecular biology and
empiric clinical observations provided a basis for the development of interventions utilizing the potential
regenerative properties of stem cells obtained from adipose tissue and perivascular tissue components [2,7,8] .

SAMPLING PLASTIC SURGEONS’ VISIONS REGARDING TRENDS IN FACIAL PLASTIC
SURGERY
A review of the literature was conducted using the following keywords as search criteria: nanotechnology,
nanocosmeceuticals, and regenerative procedures for facial and neck rejuvenation. The results of this