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There has been an increasing interest in addressing the issue of submental fat (SMF) when it comes to cosmetic medicine. With the rise of social media, video calls, and the now almost omnipresent accessibility of cameras, there is perhaps now more than ever an emphasis on the facial image. Although invasive procedures such as liposuction and neck lift still play a significant role in reducing SMF, the trend toward minimally invasive methods has finally given rise to a single Food and Drug Administration-approved injectable that is both safe and effective: ATX-101, also known as Kybella in the United States.

Basal cell carcinoma (BCC) is the most common human malignancy. Both epidemiological and direct evidence have established ultraviolet (UV) exposure from the sun as the most important risk factor for BCC development. There has only been one randomized and controlled study to examine sunscreen's role in the prevention of BCC, and no significant protective benefit was found. This study did not address four important concepts: sunscreen abuse, sunscreen misuse, sunscreen formulation, and cumulative UV exposure. Thus, the results of this study are difficult to interpret and extrapolate with real-world sunscreen practices.

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BACKGROUND The various techniques of upper blepharoplasty have been compared based on surgical time to perform the procedure, postoperative healing, scar cosmesis, and cost. Few studies have evaluated the histology of the excised tissue, and no study has compared the tissue histology of 3 blepharoplasty methods using scalpel, microdissection needle with electrocautery, and CO2 laser excision in the same patient. OBJECTIVE To evaluate the histologic changes of tissue after removal of upper eyelid skin using scalpel incision, microdissection electrocautery needle, and CO2 laser. METHODS Upper blepharoplasty skin excisions were examined from specimens obtained using scalpel incision, microdissection needle tip with electrocautery, and CO2 continuous wave beam. The specimens were sent for permanent sections for histologic evaluation. RESULTS The skin that was removed using cold steel scalpel incision showed no cellular necrosis or heat artifact. The tissue treated with the CO2 laser demonstrated significant thermal injury, including loss of cellular polarity, keratinocyte necrosis, and separation of the epidermis from the basement membrane. The skin excised using the electrocautery microdissection needle demonstrated fulguration artifact, including spindling of the epidermal nuclei with palisading of the keratinocytes. Necrosis was not prominent in the electrocautery microdissection needle specimens. CONCLUSION The amount of histologic tissue injury was greatest in the skin treated with continuous wave CO2 laser, followed by the microdissection needle with electrocautery. The cold steel scalpel incision showed no cellular necrosis.

Background: Submental fat can be reduced with ATX-101 (deoxycholic acid injection), a customizable and minimally invasive alternative to liposuction. In the years since its approval, the treatment patterns of ATX-101 have evolved. Methods: A panel of experienced physicians from the United States gathered to generate best practices for the use of ATX-101 in submental contouring. Results: The expert panel provided their insights on appropriate patient selection, managing patient expectations of ATX-101 treatment outcomes, and adverse events, and guidance on ATX-101 administration for optimal outcomes are presented here. Conclusion: These best clinical practices on the use of ATX-101 for the reduction of submental fat should enable physicians to enhance the patient treatment experience and outcomes.