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Page 6 of 8 Dobke et al. Plast Aesthet Res 2020;7:1 I http://dx.doi.org/10.20517/2347-9264.2019.65

Figure 4. A vial of mVASC with the lyophilized and sterilized pellet containing microvascular tissue fragments. The standardized
formulation of mVASC contains an amount of the graft dispersed into one vial such that is ready for dilution, and forms isotonic solution
upon the addition of 1 mL of sterile water

its architecture, and thickness, which - no doubt - will find future aesthetic applications because results of
ongoing trials are so encouraging [8,20] .

CONCLUSION
Notably, the survey demonstrated that such modalities as tissue contouring by energy delivering devices,
refinements in surgical techniques, alterations in skin and gut microbiota, and transplantation-based (other
than adipose tissue) methods were perceived as methods that exert a lesser effect on the future management of
facial and neck aging than those “top modalities” including nano and regenerative techniques [16,19,20] [Table 1].

Considering the relatively fast-paced changes and progress in cosmetic surgery and medicine, as well as the
novelties that are frequently thrown on the market - oftentimes without prior rigorous clinical studies or
trials - suggests that words of caution are appropriate. Recipients of cosmetic care are particularly vulnerable
due to the fact that, in many countries, cosmeceuticals are not regulated as rigorously as pharmaceutical
drugs, and there is also the risk of addiction to aesthetic procedures. Patients may develop a psychological
obsession with repeated or multiple cosmetic procedures and may obsessively seek invasive and non-
invasive aesthetic novelties. These patients lose objectivity and criticism, and oftentimes become victims
of unscrupulous providers. Even those who observe safety issues may not appreciate the importance of
the fact that there is a separate categorization of the quality of evidence and strength of recommendations
available [22,23] . Failure to recognize the quality of evidence can lead to misguided recommendations. The
assessment of trends and developments in facial and neck rejuvenation requires particular attention to the
quality of research available prior to its clinical application, as emerging evidence includes an element of
uncertainty about tradeoffs - the balance among safety and desirable and undesirable effects is not well-
defined. With the inevitability of scientific progress, this new level of knowledge regarding the variability in
care responses and indications for procedures on almost a “molecular level” will likely lead to personalized
and precise aesthetic surgery and medicine becoming a nearby reality.