A new option for neck rejuvenation without traditional surgical incisions is now available to patients through a hybrid non-surgical procedure offered by Amir Ghaznavi, MD, MBA, FACS, a dual board-certified plastic and reconstructive surgeon, practicing in Herndon, Va, at AMG Plastic Surgery.

Combining Established Technologies

The procedure integrates three technologies: MyEllevate suture suspension, liposuction, and Renuvion (J-Plasma) radiofrequency skin tightening. According to Ghaznavi, the combination enables targeted treatment of submental fullness, skin laxity, and jawline definition with minimal invasiveness.

“MyEllevate helps provide structural support and contour, while liposuction removes excess fat and Renuvion tightens the skin,” said Ghaznavi. “Each element addresses a different anatomical concern without requiring open surgery.”

Addressing Patient Demand for Minimally Invasive Options

The technique is designed for patients in their 30s to 60s who want visible improvements in their neck and jawline without undergoing a full neck lift. Results are typically seen immediately, with further skin tightening continuing in the months following the procedure. No visible scarring and reduced recovery time are among its key advantages.

Ghaznavi noted that the procedure is suited for individuals who are not yet candidates for surgical intervention or prefer to avoid the downtime associated with more invasive techniques.

Implications for Private Practice Surgeons

The hybrid approach reflects a growing trend among patients seeking non-surgical or minimally invasive cosmetic procedures. For plastic surgeons in private practice, offering combination therapies may meet increasing demand for results-driven treatments that fall between injectables and traditional surgery.

Photo: AMG Plastic Surgery

Emface, a non-invasive facial treatment designed to treat both the skin and underlying muscles for a more youthful, lifted appearance, has reached 1 million treatments worldwide in under two years. 

“The ability to stimulate elevator muscles allows us to lift facial features from within—something that was never possible before with injectables or traditional energy-based devices,” says Yael Halaas, MD, FACS, a facial plastic surgeon from NYC, USA.

Developed by BTL, Emface has expanded its capabilities over the past year with the introduction of specialized submental and under-eye applicators. The latest eye applicators received positive feedback from attending medical experts upon their launch at the IMCAS World Conference in Paris in January 2025, according to a release from the company.

“Emface isn’t just a procedure—it’s a facial multiplatform that allows us to treat different areas based on each patient’s unique needs. It’s a game-changer for anyone looking for natural-looking facial rejuvenation,” says Kyungkook Hong, MD, PhD, a board-certified dermatologist from Seoul, Korea.

More practitioners continue to integrate Emface into their treatment offerings, according to the company. 

“Reaching 1 million treatments in just two years is a testament to Emface’s groundbreaking technology and the value it brings to medical professionals,” says Tomas Schwarz, CEO of BTL, in a release. “We remain committed to expanding this platform and further advancing non-invasive facial treatments in the years ahead.”

BTL’s products include Emsculpt Neo, Emface, Exion, Emsella, Exomind, as well as HIFEM, HIFES, and EXOTMS procedures. 

Photo caption: Before and after photos of a patient receiving Emface

Photo credit: BTL courtesy of Joel L. Cohen, MD

Key Takeaways

1. The Corset Contour procedure reshapes and repositions the lower ribs without removing them, creating a slimmer, hourglass-shaped waistline.
2. Ultrasound-guided precision is used to adjust the floating ribs (11 and 12) while maintaining their structural integrity, offering a natural appearance.
3. The procedure provides long-lasting results and can be combined with other techniques, such as liposuction or a tummy tuck, with minimal scarring.

———————————————————————————————————————————————————
Houston-based Morales Plastic Surgery, led by Rolando Morales, MD, announces the launch of the Corset Contour procedure, designed to deliver a more defined, hourglass-shaped waistline. The Corset Contour reshapes and repositions the lower ribs without the need for rib removal, providing a slimmer, more proportionate waistline.

Unlike traditional rib removal, this method adjusts the shape and position of ribs 11 and 12—the floating ribs—using ultrasound-guided precision. This maintains the ribs’ structural integrity while allowing patients to achieve a “snatched” waistline with a natural appearance.

Inside the Corset Contour Procedure

“The Corset Contour is an excellent option for individuals who have struggled to achieve their ideal body shape through diet and exercise alone. This procedure is designed to provide long-lasting results that enhance body proportions while ensuring the patient’s safety and comfort,” says Morales.

The Corset Contour procedure reshapes the lower ribs to create a narrower waist. It provides lasting results and can be combined with techniques like liposuction or a tummy tuck.

During the procedure, ultrasound imaging helps locate and reshape the lower ribs. Through small incisions, the rib structure is adjusted with minimal scarring. After surgery, patients wear a compression garment and corset to support healing, with results improving over time.

Key Takeaways:

1. Dr. Thomas A. Pane explains that free nipple grafts are rarely necessary during mommy makeovers for large-breasted patients, as he focuses on preserving the nipple with the natural tissue whenever possible.
2. Free nipple grafts may be required if the supporting tissue is too large, which can make breast closure difficult or unsafe, but they come with drawbacks such as loss of sensation and the inability to breastfeed.
3. Dr. Pane emphasizes the importance of personalized patient assessments to ensure safe, effective procedures with minimal risk and optimal outcomes.

————————————————————————————————————————————————

Thomas A. Pane, MD, a double-board certified plastic surgeon and founder of Atlantic Coast Aesthetics in Palm Beach Gardens, Fla., has released a new blog and video in his “Ask Dr. Pane” series. This installment addresses a question from a social media follower about the necessity of a free nipple graft during a mommy makeover for individuals with large breasts.

In the blog, Pane responds to the question, “I’m having a mommy makeover; I have large breasts do I need a free nipple graft?” He explains that when he performs a breast lift or reduction, the external scars typically form an inverted T shape, circling around the areola, down the breast, and along the base curve. However, the internal technique can vary.

Nipple Preservation in Breast Surgeries

Pane focuses on preserving the nipple by carrying it on a segment of tissue as it’s repositioned. “While it’s rare for me to encounter cases where the nipple needs to be completely removed as a free nipple graft, it can happen if the breasts are exceptionally large,” he says.

He explains that a free nipple graft may be necessary when the tissue segment supporting the nipple is extremely large and long, making the closure of the breast difficult or unsafe. The drawbacks of a free nipple graft include the loss of sensation and the inability to breastfeed, he says, making it a less preferable option compared to preserving the nipple with the natural tissue.

“Fortunately, in my practice, these instances are uncommon, thanks to the techniques I’ve learned and refined over time,” Pane says. “While I’ve integrated a combination of techniques into my practice, the emphasis on preserving the nipple whenever possible stems from this early training.”

Personalized Patient Assessments

Finally, Pane highlights the importance of carefully assessing each patient, considering factors like breast size, sensation, and overall health. “Ultimately, our goal is to provide safe, effective procedures with minimal risk and optimal outcomes,” he says. “We encourage anyone with questions or concerns to reach out, and we’ll be happy to address them.”

Louis Scafuri, Sofwave’s CEO, said, “We are pleased to receive FDA clearance for improvement of the appearance of skin laxity on the upper arms in the U.S. supported by compelling clinical study results. Lax skin on the upper arms is a prevalent issue that can impact individuals not only from a physical appearance aspect but also emotionally. Whether the presence of sagging or loose skin on their upper arms is a result of aging, weight loss, genetics, or a combination of factors, the results of our upper arm laxity study provide a clear, objective clinical data set and patient outcomes further advancing our progress to become the leading provider of choice in the growing non-invasive medical aesthetic industry. We look forward to continuing to expand the use of our innovative technology to other aesthetic treatment applications throughout the body.

According to the American Society of Plastic Surgeons, 2022 Procedural Statistics Release, 2019-2022, brachioplasty (surgical arm lift) procedures grew 25%. According to the Sofwave, its SUPERB platform introduces a viable FDA-cleared, non-invasive alternative to improve the appearance of skin laxity on the upper arms without the associated risks and recovery time of conventional surgery, laser-based body contouring, and other minimally invasive procedures.

The study leading to FDA clearance of premarket notification submission included a total of 46 subjects who were enrolled and treated on both upper arms at four sites in the United States. Subjects attended two treatment sessions (1-3 weeks apart) and a follow-up visit 3 months after the final treatment visit. Of the treated arms, 93% were “improved” or “very much improved” in appearance, as rated by the blinded reviewers using the Global Aesthetic Improvement Scale. Most subjects reported none to mild levels of pain during treatment and no discomfort afterward.

In the United States, Sofwave’s technology is currently cleared for use as a non-invasive aesthetic treatment to improve facial lines and wrinkles, lift the eyebrow, and lift lax submental (beneath the chin) and neck tissue; which can also affect the appearance of lax tissue in the submental and neck regions for subjects aged 22 and older. The Sofwave system is also cleared for short-term improvement in the appearance of cellulite and for the treatment of acne scars.

“Taking advantage of quality-improvement data submitted by US Board-certified plastic surgeons, our study provides new insight on the evolution of the abdominoplasty technique,” comments lead author Michael J. Stein, MD, MAS, FRCSC, FACS of Lenox Hill Hospital in New York, N.Y.

Shifts in ‘Tummy Tuck’ Techniques and Outcomes 

Abdominoplasty—sometimes called “tummy tuck”—is a cosmetic surgical procedure to improve the appearance of the abdomen. In 2022, ASPS Member Surgeons performed nearly 162,000 breast augmentation procedures, according to ASPS statistics.

To assess the evolution of practice patterns and surgical techniques, Stein and colleagues analyzed data from the Continuous Certification process of the American Board of Plastic Surgery (ABPS). In that process, plastic surgeons submit information on specific “tracer procedures” as evidence of ongoing improvement in clinical practice.

The researchers analyzed data on 8,990 abdominoplasty cases submitted by 390 ABPS-certified plastic surgeons between 2005 and 2021. To assess trends over time, cases were divided into early (2005-14) and recent (2015-21) cohorts.

The study period saw an increased rate of outpatient abdominoplasty, without an overnight hospital stay, from 77% to 81%; and increased use of heparin to prevent blood clot-related complications. Patients treated in more recent years were more likely to undergo multiple surgical procedures, particularly liposuction to reduce fat in the abdominal tissue flap.

Abdominoplasty Safety

Other technical changes included decreased use of wide tissue undermining, vertical plication of the abdomen and postoperative surgical drains—although all these techniques continued to be used in most abdominoplasty cases. The researchers note that while the observed changes are statistically significant, they are “best appreciated as positive or negative practice trends between cohorts, rather than clinically significant changes in practice.”

“Abdominoplasty remains a safe and reliable procedure over the study period, with a slight but statistically significant decrease in adverse events in the recent cohort,” Stein and coauthors conclude. “Careful preoperative evaluation of patients should identify risk factors that increase the risk of complications.”

Senior author and past ASPS President Alan Matarasso, MD, of Manhattan Eye Ear and Throat Hospital has contributed to similar reviews using ABPS Continuous Certification data for other “tracer” procedures – most recently including a report on trends in cosmetic breast augmentation. Fellow authors include Arun Gosain, MD, and Peter Rubin, MD.

“While not without potential sources of bias, the use of ABPS Continuous Certification data – with mandatory reporting of large numbers of common procedures by Board-certified plastic surgeons – provides unique insights into trends in surgical practice and benchmarks to inform further safety and quality improvement efforts,” Matarasso adds.

“While most patients regain some weight after BC surgery, those who have undergone bariatric surgery gain slightly more weight at long-term follow-up,” says lead author Joshua T. Henderson, MD, of West Virginia University Division of Plastic, Reconstructive, and Hand Surgery, Morgantown. “Our findings should not challenge the benefit of BC for patients with massive weight loss, but they do clarify the outcomes that patients and surgeons can expect in the years after surgery.”

New Findings on Post-Body Contouring Weight Gain

Body contouring refers to a range of surgical procedures to remove excess skin and soft tissue in patients with major weight loss, with the aim of “improving patients’ quality of life, increasing function and further motivating healthy lifestyles,” according to the authors. However, there are limited data on how BC surgery affects weight control—including potential differences between patients who underwent bariatric surgery compared to other groups of patients with massive weight loss.

Henderson and his colleagues analyzed weight regain after trunk-based BC surgery in 121 patients, 60 of whom had previously undergone bariatric surgery. Multiple measures of body weight were monitored at an average follow-up period of about 3.5 years. The two groups were similar in terms of initial body weight before undergoing BC. The study focused primarily on the effects of removing excess abdominal skin, hence surgery consisted of either panniculectomy or abdominoplasty (“tummy tuck”).

Compared to immediately before BC surgery, the patients had an average increase of 2.30% of body weight during long-term follow-up. Weight gain was significantly greater in the bariatric surgery group: 4.39%, compared to 0.25% in non-bariatric patients.

Average time to lowest (nadir) body weight after BC surgery was about four months. From this point, weight regain through long-term follow-up was 11.81% in patients who had undergone bariatric surgery, compared to 7.56% in the non-bariatric group.

Seeking Revised Metrics for Long-Term Body Contouring Outcomes

Previous studies of long-term weight control after BC surgery have focused mainly on bariatric surgery patients, with little information on other groups of patients. Studies have also used varying measures of body weight—for example, absolute versus percent total weight loss versus percent excess weight loss.

Percent change (loss) in total and excess weight “should become standard” in evaluating the long-term outcomes of BC surgery, Henderson and his colleagues believe. They write, “Weight control at long-term follow-up should also be the focus, rather than maximum weight loss.”

While weight regain is somewhat greater for bariatric surgery patients, “All patients tend to regain weight after achieving their nadir following trunk-based BC surgeries, eventually surpassing their preoperative weight,” the researchers add.

“This is not clinically surprising, nor does it contend with the psychological benefits of [BC surgery],” Henderson and his colleagues conclude. “It primarily increases the confidence with which these patients can receive counsel of their expected postoperative course.”

The growing demand for arm lifts, particularly after weight loss, is becoming an increasingly popular way for patients to feel more comfortable in their clothes and with their bodies. The trend underscores the transformative impact aesthetic surgeries can have on people’s physical health and self-esteem.

Explaining this surge, Hardaway says, “We’re observing an increased interest in arm lifts from patients who’ve recently undergone significant weight loss, either through bariatric surgery or certain weight loss drugs, such as Ozempic. This surgical procedure, also known as brachioplasty, helps patients tighten and tone their upper arms, enhancing their overall appearance.”

An arm lift is a surgical procedure that sculpts the upper arm by removing excess skin and fat. This has proven particularly beneficial for post-bariatric and weight-loss drug users who may experience excess, sagging skin.

“Many patients express increased comfort and confidence in exposing their arms and wearing a wider range of clothing styles following their procedures,” adds Hardaway.

Movie characters who undergo successful plastic surgery to improve their facial appearance are more likely to have happy endings, according to the new research by Young Suk Kim, BA, and Kun Hwang, MD, PhD, of Armed Forces Capital Hospital in Gyeonggi-do, Korea. They believe their findings relate to the cultural meanings of facial disfigurement, as well as to the psychological benefits of facial plastic surgery.

Negative Associations with Facial Disfigurement

The researchers searched movie databases—IMDb (Internet Movie Database) and TMDB (The Movie Database)—to identify modern visual media depicting characters with disfigured faces. The analysis included 48 characters from 45 films directly related to the theme of facial disfiguration. While most films were from the United States, countries around the world were represented.

The movies were produced between the 1930s to the 2020s, with the highest proportion (20%) from the 1980s. Nearly three-fourths of characters were rated as being in the most severe categories of facial disfigurement. Examples of films with characters having “critical” facial disfigurement included The Elephant Man and Mask.

About 80% of disfigured characters were viewed as negative, described by terms such as demonic, villainous, or violent. Just 20% were described positively—for example, hero or human. “This seems to implicitly reflect the creators’ biased view that presents disfigured faces in a negative light,” the researchers write. After adjustment for other factors, society’s perceptions of disfigured faces were not related to their effect on personality. Rather, the authors suggest, “a negative personality was formed due to psychological atrophy and self-esteem problems, not the disfigured face itself.”

Facial Surgery Linked to Happy Endings

In the films, 35% of characters underwent surgery to overcome their facial disfigurement. Other types of attempts included masks or magic. The attempts improved the character’s facial appearance in about 70% of cases, including 94% of those who underwent surgery. Characters who underwent surgery were 56 times more likely to improve than those who tried other treatments.

Overall, 67% of characters had fortunate or happy endings, while the rest had misfortunate endings. Characters whose appearance improved were more likely to have happy endings: nearly eight times more likely than those who did not improve. The researchers add, “It is notable that some characters experienced misfortune even though their facial damage improved, while others became happy without improvement.”

The authors discuss their findings in the context of the cultural and psychological meanings of facial disfigurement. The association between successful surgery and happy endings for characters with facial disfigurement is consistent with evidence on the positive psychological effects of plastic surgery for disfigured individuals.

Despite its many risks and side effects, “there is no doubt that facial plastic surgery enhances overall well-being and self-confidence,” the researchers conclude. “The results of this film analysis study, which showed plastic surgery can improve the face and improve quality of life, can be seen as realistic and statistically significant.”

This bill was sent to the governor’s office who signed it into law. As of July 1, Florida physicians who perform gluteal fat grafting must use ultrasound guidance to clearly see that fat is injected only in the subcutaneous space and never into the muscle. When fat graft have inadvertently been injected into the gluteal muscle, the fat has traveled to the heart, lungs, and brain with fatal results.

“We’re elated that ultrasound is now the law of the land in Florida for BBLs. This is the first time a plastic surgery law has passed,” says plastic surgeon  Pat Pazmiño MD, FACS. “The Florida Society of Plastic Surgeons has worked for decades as advocates for patient safety. We were honored to sponsor this bill and lobby government officials to protect patients. We are grateful that Governor DeSantis signed our bill into law and helped make legislative history! And we’re also thankful to the team at Clarius for their incredible help and support.” 

Gluteal fat grafts, or Brazilian Butt Lifts (BBLs) as they are commonly known, are considered to have one of the highest mortality rates of any cosmetic surgery, according to the American Society of Plastic Surgeons. To ensure safer procedures, the new Florida law also mandates that surgeons cannot meet the patient for the first time on the day of the surgery and that a surgeon cannot delegate the surgical procedure to a nurse or an assistant.

Pazmiño has used ultrasound at his Miami practice for more than a decade and created the ultraBBL^TM procedure, which combines innovative aesthetic surgery techniques with ultrasound guidance to ensure the safest outcomes. He currently uses the Clarius L7 HD₃ wireless ultrasound. 

Amanda Leyva, a patient who underwent BBL surgery a year ago, says she thought long and hard before undergoing the procedure. Her research to find the best plastic surgeon in Miami led her to Pazmiño. 

“I was really excited to meet with him in person for a consult as most plastic surgeons in the area just want you to send in photos and then you go in for surgery before you’ve met them,” she said in a recent video interview. “We talked about the procedure and about how he does it a little bit differently with the ultrasound technology that it makes it so much safer. Knowing that Dr. Pazmiño uses ultrasound gave me the confidence that I would be ok. It gave me exactly what I was looking for. There were no complications, everything went really well.” 

The new Florida State law follows the adoption of the 90-day Emergency Rule (64B8ER22-3) filed by the Board of Medicine and authorized by the Florida Department of State on June 14^th, 2022. It also mandated the use of “ultrasound guidance when placing and navigating the cannula and injecting fat into the subcutaneous space,” and furthermore, required the surgeon to “maintain the ultrasound video recording in the patient’s medical record including the time and the date stamp.” 

“Within a month of the Emergency Rule, roughly half of the plastic surgeons in the state acquired a Clarius wireless scanner, rather than canceling surgeries,” says Clarius President and CEO Ohad Arazi. 

“The Clarius L7 HD₃ delivers high-resolution imaging to improve procedural safety in an affordable ultrasound solution that features advanced plastic surgery software, a dedicated BBL Preset, and Procedure Recording Mode to help surgeons stay ahead of evolving regulations,” Arazi adds. “At Clarius, we’re grateful for our close collaboration with trailblazing physicians like Dr. Pat Pazmiño who help pave the way for better patient safety.”  

Plastic surgeons are invited to visit the Clarius Classroom and webinar center for free video resources to learn industry leading ultrasound best practices. They feature renowned plastic surgeons like Pat Pazmiño, MD, FACS, Marc Salzman, MD, FACS, Steven Weiner, MD, Alexis Delobaux, MD, and others who share best practices for improving patient safety across a variety of aesthetic procedures, from BBLs, to breast surveillance, to facial fillers.