Journal of Applied Cosmetology

Feasibility of Shockwave Therapy and Standardization of Dosage for Mild to Moderate Forehead Acne

Peeyoosha Gurudut — 2025-09-23

Acne vulgaris, the most common dermatological condition globally, has a reported prevalence of 0.74% in India. Topical clindamycin remains a first-line treatment, particularly for acne scars. Recent evidence suggests extracorporeal shockwave therapy (ESWT) may support a favorable environment for treating active acne and post-acne scarring. However, limited data exist on the combined use of ESWT and clindamycin in the management of acne. This study aimed to assess the efficacy of ESWT, both alone and as an adjunct to clindamycin, in reducing acne severity, lesion count, and enhancing quality of life and patient satisfaction. It also aimed to determine the optimal ESWT dosage for achieving therapeutic benefits. To evaluate the efficacy of ESWT in mild to moderate papular forehead acne based on acne severity, number of lesions, quality of life, and patients’ satisfaction, and to determine the most effective ESWT dosage, thirty individuals were screened, with 24 participants (aged 12–29 years) meeting the inclusion criteria. They were randomly divided into three groups based on ESWT dosage: Group A (200 impulses), Group B (300 impulses), and Group C (400 impulses). Each participant received three ESWT sessions, administered on alternate days over a one-week period, along with topical clindamycin. Outcomes were assessed at baseline and post-intervention using the Investigator’s Global Assessment (IGA), Acne-QoL questionnaire, lesion photography, and Patient Satisfaction Scale. Paired t-tests revealed significant Intra-group improvements (p = 0.001) in all outcome measures. One-way ANOVA indicated significant inter-group differences in post-intervention acne severity (p = 0.035) and lesion count (p = 0.005), with Group B exhibiting the greatest improvement. No significant intergroup differences were observed for quality of life (p = 0.170) or patient satisfaction (p = 0.116). ESWT, particularly at moderate dosage (300 impulses), is effective and safe in treating forehead acne. When combined with clindamycin, it improves the severity of acne and supports overall patient outcomes.

Quantum Molecular Resonance scalpel QMR and its potential applications in Aesthetic Phlebology

P. A. Bacci — 2025-09-29

Officially recognized internationally, sclerotherapy is the primary treatment for varicose veins, spider veins, and telangiectasias. Electromicrocoagulation is also used to treat red and blue capillaries. This work aims to evaluate the effectiveness of a novel microelectrotherapy strategy in reducing complications associated with thermal damage. Advances in bioelectronic engineering have led to new treatment options through Quantum Molecular Resonance (QMR), a novel strategy applied in regenerative medicine for organ and tissue regeneration by adult stem cell activation, in physiotherapy due to its strong anti-inflammatory and regenerative effects, in neurosurgery and other surgical fields for its potential in developing a "low-temperature QMR electric scalpel”. This new type of electric scalpel can also be used in phlebology to treat dermal capillaries and varicosities, thanks to its adjustable power and precise timing, which help reduce thermal damage. The use of microcoagulation with a QMR-based bioelectronic scalpel has shown promising results, significantly reducing skin thermal heating during the treatment of capillaries, varicosities, and telangiectasias. When combined with microsclerotherapy, it reduces the risk of inflammatory responses and pigmentation, giving rise to a new technique called "QMR microscleroresonance", which represents a promising advancement in Aesthetic Phlebology.

Gluteal Augmentation with Hyaluronic Acid Injection: Technique, Safety and Patient Satisfaction

H. A. S. Abdallah — 2025-10-23

The modern aesthetic ideal emphasizes a defined waistline, sculpted curves, and a voluminous, lifted buttock, making the gluteal region a key focus in cosmetic medicine. Among the available options, hyaluronic acid (HA) fillers have emerged as a safe, minimally invasive, and reversible alternative to surgical methods such as gluteal implants or fat grafting, which are associated with higher complication rates and longer recovery times. This prospective study evaluates the efficacy, safety, and patient satisfaction of gluteal augmentation using a standardized protocol of HA filler injections. A total of 40 female patients, aged between 28 and 45 years and with a body mass index (BMI) between 18 and 25 kg/m2, were treated using blunt-tip cannulas and medium molecular weight HA injected into the deep subcutaneous layer. Injection planning was based on individualized anthropometric analysis and precise anatomical landmarking. The procedure was performed in a certified clinical setting under sterile conditions and with appropriate anesthetic support. The results demonstrated immediate and natural-looking volume enhancement, with excellent tissue integration and aesthetic improvement lasting up to 12 months. Patient satisfaction was notably high, with 95% of participants reporting being satisfied or very satisfied with the outcome in terms of shape, symmetry, and projection. Follow-up assessments at 7 to 14 days and again at 3 to 6 months confirmed stable results and sustained satisfaction. Adverse effects were limited to mild and transient events such as bruising, pain, and swelling, without any cases of serious complications, allergic reactions, or the need for enzymatic reversal. The HA formulation used in this study is Privilege Body- 10 ml syringe format, which represents a new generation of body fillers, specifically designed to combine the volumizing properties of high molecular weight HA with the cohesiveness and reversibility of lower molecular weight formulations. Unlike permanent fillers, such as silicone or acrylic materials, now banned due to the risk of granulomas, migration, and infections, this medium molecular weight HA is fully biodegradable and can be safely dissolved with hyaluronidase in case of need. These characteristics make it particularly suitable for large-volume, high-precision applications like gluteal remodeling. In conclusion, hyaluronic acid-based gluteal augmentation is a viable, effective, and safe option for selected patients seeking moderate body enhancement without the risks or downtime associated with surgery. The key to success lies in careful patient selection, a solid understanding of gluteal anatomy, and adherence to a standardized technique. While the cost of HA may be higher than fat grafting, its predictability, minimal invasiveness, and favorable safety profile make it a valuable tool in the expanding field of non-surgical body contouring. Future comparative and long-term studies will be essential to further validate and refine this approach.

Quantum Molecular Resonance (QMR®) for Delayed Inflammatory Reaction to Gluteal Hyaluronic Acid Filler: Case Report

Pier Antonio Bacci — 2025-12-05

Injectable hyaluronic acid (HA) fillers are widely used in minimally invasive aesthetic medicine for facial and body rejuvenation, as well as for gluteal volumization and contouring. The extensive international use of fillers with various substances has revealed a considerable number of complications that must be recognized for both preventive and therapeutic purposes. The aim of this report is to describe a case of a severe inflammatory reaction occurring 21 days after the injection of 60 cc of HA per gluteal side in a patient who had undergone quadrantectomy for unilateral breast cancer eight months prior, with a negative total-body bone scan, no chemotherapy, and overall good physical and psychological condition. The patient was on tamoxifen therapy in preparation for adnexectomy/total hysterectomy; in agreement with her oncologist and at her request, tamoxifen had been suspended 15 days before the filler injections. The case demonstrated a rapid anti-inflammatory effect achieved exclusively through Quantum Molecular Resonance (QMR®) therapy. The treatment employed Quantum Molecular Resonance (QMR®) technology, widely used in regenerative medicine and physiotherapy for its anti-inflammatory and regenerative effects, mediated through the activation of adult stem cells. The non-invasive protocol consisted of six 20-minute sessions per side, with a 2-day interval between consecutive sessions. QMR® treatment resulted in rapid symptom improvement, with reductions in pain, erythema, and a sensation of tension, without the need for additional corticosteroid therapy. Guidelines for complications related to gluteal hyaluronic acid fillers typically include antibiotic therapy, corticosteroids, possible aspiration, or hyaluronidase. In more severe cases, surgical intervention may be required. In the present case, the patient explicitly requested to avoid corticosteroids. QMR® treatment produced an effective anti-inflammatory response, preventing fibrotic progression and allowing the preservation of the implant. The technology demonstrated both efficacy and scientific plausibility; however, further studies are needed regarding its indications. Nevertheless, this case suggests that QMR® may represent a valid alternative or a useful adjunct to conventional therapeutic strategies for filler-related complications.

Dual Core: A Mechanical, Biological, and Metabolic Model for Physiological Bio-regeneration with PEG-Crosslinked Hyaluronic Acid Fillers

M. Basso — 2025-12-30

This proof-of-concept article introduces the “Dual Core Concept”, a novel facial rejuvenation model integrating complementary mechanical, biological, and metabolic processes within a single synergistic framework. The concept focuses on Neauvia Stimulate, a PEG-crosslinked hyaluronic acid (PEG-HA) filler enriched with calcium hydroxyapatite (CaHA), which intrinsically embodies two “cores”: the mechanical core providing immediate structural lift and the biological core inducing progressive dermal regeneration. To reinforce deep anatomical support, Neauvia Intense may be used concomitantly as a structural scaffold, optimizing the environment for superficial and mid-fat layer regeneration. Drawing on histological, clinical, and biochemical evidence, this model illustrates the evolution of aesthetic medicine from volumetric correction toward physiological bio-regeneration, emphasizing precise anatomical targeting and the “less-is-more” principle of natural tissue restoration. This integrative approach represents a paradigm shift from static correction to functional, multi-layered rejuvenation aligned with the physiology of facial tissues.