Facial Plastic Surgery Clinics RSS feed. https://www.facialplastic.theclinics.com/issues?journalCode=fsc&publicationCode=fsc&rss=yes Elsevier Inc. en © 2026 Published by Elsevier Inc. All rights reserved. Facial Plastic Surgery Clinics 1064-7406 2026-06-17-07:00 © 2026 Published by Elsevier Inc. All rights reserved. permissionshelpdesk@elsevier.com https://www.facialplastic.theclinics.com/article/S1064-7406(26)00039-8/fulltext?rss=yes Exosomes are a subtype of extracellular vesicles, critical for intercellular communication. They are released from a cell via exocytosis, after which they travel through the extracellular fluid until they reach a target cell. Research in the fields of cellular medicine, regenerative and stem cell therapy continues to grow exponentially. Deciphering the biological properties of mesenchymal stem cells-exosomes as cell-free therapeutic tools is important for wound healing and cutaneous regeneration. The future is also bright for genetically engineering exosomes for targeted diagnostic and therapeutic applications. The Role of Human Placental Mesenchymal Stem Cell Derived Exosomes in Wound Healing and Scar Therapy Greg Chernoff, Jenna Himelstein 10.1016/j.fsc.2026.05.004 Facial Plastic Surgery Clinics (2026) 2026-06-17 Facial Plastic Surgery Clinics 2026-06-17 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00040-4/fulltext?rss=yes This article reviews the clinical application of direct injection of stem cells and differentiated cells, comparing established European experience with the rapidly evolving regenerative medicine landscape in Dubai. It highlights the strongest evidence in orthopedic applications, outlines current limitations in standardization and long-term outcomes, and examines emerging technologies such as exosomes and engineered cellular therapies. Differences in regulatory frameworks and clinical adoption are discussed, emphasizing the need for continued evidence-based integration and ethical oversight in the expansion of regenerative medicine. Direct Injection of Stem Cells and Differentiated Cells Jaffer Khan, Zara Yousufzai 10.1016/j.fsc.2026.05.005 Facial Plastic Surgery Clinics (2026) 2026-06-12 Facial Plastic Surgery Clinics 2026-06-12 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00038-6/fulltext?rss=yes Regenerative strategies in facial plastic surgery increasingly incorporate platelet-rich fibrin, platelet-rich plasma, fat grafting, and emerging biologic agents. Despite widespread adoption, outcomes remain variable, in part due to limited control of upstream processes such as perfusion, extracellular matrix remodeling, and stem cell niche stability. To review the mechanistic basis and emerging clinical evidence supporting bioelectric modulation as a systems-level regulator of regenerative pathways relevant to facial rejuvenation, wound healing, and hair restoration. Bioelectric modulation represents a plausible investigational adjunct to biologic therapies in facial plastic surgery. Further studies are required to define efficacy, optimize treatment parameters, and evaluate long-term safety. Bioelectric Modulation as a Systems-Level Adjunct to Regenerative Therapies in Facial Plastic Surgery and Hair Restoration Howard J. Leonhardt, Gregory Keller, Allison Pontius 10.1016/j.fsc.2026.05.003 Facial Plastic Surgery Clinics (2026) 2026-06-12 Facial Plastic Surgery Clinics 2026-06-12 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00042-8/fulltext?rss=yes Goals in plastic surgery and aesthetic medicine include minimizing healing complications, optimize aesthetic outcomes and improve patient satisfaction. Platelet-derived growth factor BB (PDGF-BB) is among the most potent natural activators of healing. A pharmaceutical copy of natural PDGF-BB, (rhPDGF-BB or pure PDGF) is the active ingredient in four US Food and Drug Administration-approved therapies to stimulate healing of skin, mucosa, gingivae or bone. Here we describe the mechanism of action and clinical uses of off-the-shelf pure PDGF in plastic surgery and aesthetic medicine as a post-treatment adjunct to enhance patient satisfaction. Clinical Applications of Pure Recombinant Human Platelet-Derived Growth Factor BB in Esthetic Medicine and Plastic Surgery Samuel E. Lynch, Christopher K. Hee, Rod Rohrich, David Weir, Tara Chadab, Aaron L. Wiegmann 10.1016/j.fsc.2026.05.007 Facial Plastic Surgery Clinics (2026) 2026-06-11 Facial Plastic Surgery Clinics 2026-06-11 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00044-1/fulltext?rss=yes This is a review of modified mRNA (mmRNA) science and a description of a novel application of mmRNA for the creation of personalized cosmetic products. A New Frontier of Cosmetic Technology Eduard Yakubov, Marc Levin, Andrew S. Frankel 10.1016/j.fsc.2026.05.009 Facial Plastic Surgery Clinics (2026) 2026-06-08 Facial Plastic Surgery Clinics 2026-06-08 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00043-X/fulltext?rss=yes This review summarizes current understanding of defensin peptides in skin and hair rejuvenation. It draws on preclinical animal models, mechanistic studies, and human clinical trials, including data on α-defensin and β-defensin formulations. Defensins are discussed in the context of regenerative peptides, growth factor–based cosmeceuticals, extracellular vesicles, safety, regulatory considerations, and heterochronic parabiosis. The goal is to provide facial plastic surgeons and aesthetic clinicians with a practical, evidence-based overview of defensin therapy and its potential integration into regenerative aesthetic practice. Defensins Sunder Gidumal, Francis Reyes Orozco, Gabrielle Cahill, Amy Forman Taub 10.1016/j.fsc.2026.05.008 Facial Plastic Surgery Clinics (2026) 2026-06-08 Facial Plastic Surgery Clinics 2026-06-08 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00041-6/fulltext?rss=yes Stem cell clinics and stem cell use are arguably subject to regulatory oversight at multiple levels including the US Food and Drug Administration (FDA), offices of attorney generals, and state medical licensing boards. Such regulatory oversight has been enforced unevenly. Two high profile appellate court cases propelled by the FDA, Department of Justice criminal prosecutions, and a US Supreme Court decision have reshuffled the deck, auguring over the next several years paradoxically for both more stringent enforcement and less enforcement. US Food and Drug Administration and Regulation Issues for Biologics Jeffrey Segal 10.1016/j.fsc.2026.05.006 Facial Plastic Surgery Clinics (2026) 2026-06-08 Facial Plastic Surgery Clinics 2026-06-08 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00037-4/fulltext?rss=yes Photobiomodulation harnesses visible and near-infrared wavelengths to modulate mitochondrial energetics and transcriptional programs that orchestrate wound repair, immune homeostasis, angiogenesis, and organized extracellular matrix remodeling. In parallel, topical or intradermal biological interventions (including exosomes, platelet-rich plasma and platelet-rich fibrin, polydeoxyribonucleotides, polynucleotides, recombinant growth factors, and bioactive peptides) deliver molecular cargo that stimulates collagen synthesis, elastin assembly, and barrier restoration. Fractional ablative and non-ablative laser systems, along with mechanical and energy-based microneedling platforms, overcome the stratum corneum barrier to facilitate substantive dermal penetration of these agents through laser-assisted drug delivery (or device-assisted drug delivery). Photobiomodulation and Biological Pathways in Skin Regeneration and Rejuvenation Saami Khalifian, Jessica Shisler 10.1016/j.fsc.2026.05.002 Facial Plastic Surgery Clinics (2026) 2026-06-08 Facial Plastic Surgery Clinics 2026-06-08 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00036-2/fulltext?rss=yes Exosomes—small extracellular vesicles containing protein, lipid, and nucleic-acid cargo—modulate key pathways involved in inflammation, angiogenesis, and extracellular matrix remodeling. This narrative review synthesizes current pre-clinical and clinical evidence supporting exosome-based interventions in cutaneous wound healing and facial skin regeneration, with attention to delivery strategies, translational limitations, and regulatory considerations relevant to facial plastic and reconstructive surgery. Across multiple in vivo models, exosome-based therapies have been associated with accelerated wound closure, enhanced neovascularization, and more organized collagen architecture, with attenuation of excessive fibrotic remodeling in later phases of healing. Exosomes in Cutaneous Wound Healing and Facial Skin Regeneration Jeffrey Janus, Jieun Lee, Allison Pontius 10.1016/j.fsc.2026.05.001 Facial Plastic Surgery Clinics (2026) 2026-06-08 Facial Plastic Surgery Clinics 2026-06-08 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00034-9/fulltext?rss=yes Today there is a growing shift in the paradigm from restorative medicine to regenerative medicine using regenerative biologics. Additional research is occurring to help solve some of the challenges of hair regeneration. While there is not a one size fits all formula for patients, further study of biologics including PRP, exosomes, PDGF, organoids, will continue to refine approaches and improve outcomes, a thorough evaluation of these approaches with consideration of not only the components but also the delivery method is key to achieving a high degree of efficacy while maintaining patient safety at the same time. Evaluation of Emerging Treatments that Activate Stem Cell Pathways for Hair Growth Carrie L. Morris, Jeffrey Epstein 10.1016/j.fsc.2026.04.004 Facial Plastic Surgery Clinics (2026) 2026-06-08 Facial Plastic Surgery Clinics 2026-06-08 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00033-7/fulltext?rss=yes Skin aging manifests as loss of collagen, thinning of the dermis, diminished epidermal turnover, and accumulation of senescent cells. Recent advances highlight the potential of biologic therapies—including stem cell secretomes, growth factors, peptides, and exosomes—to restore skin health at the molecular and cellular level. This review summarizes peer-reviewed evidence on biologic skin improvement, with emphasis on Klotho, growth factors, exosomes, bioactive peptides (including defensins), sirtuins, and senolytic approaches. Mechanistic pathways are presented, clinical outcomes are discussed, and practical considerations for facial plastic surgery are highlighted. Takeaway points underscore the synergy of combining biologic agents with established aesthetic procedures. Biologic Improvement of Skin Sunder Gidumal, Francis Reyes Orozco, Gabrielle Cahill, Allison Pontius, Gregory Keller 10.1016/j.fsc.2026.04.003 Facial Plastic Surgery Clinics (2026) 2026-06-08 Facial Plastic Surgery Clinics 2026-06-08 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00029-5/fulltext?rss=yes This systematic review evaluates the effectiveness of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) for periorbital rejuvenation, updating a previous 2021 review. Twenty-six studies were included with notable variability in preparation methods limiting clear conclusions. Patient satisfaction was high with PRP/PRF treatment, which was only moderately effective for periorbital hyperpigmentation, and objective improvements for wrinkles and skin texture were mixed. Clinical use is described. Platelet-Rich Plasma and Platelet-Rich Fibrin in Periorbital Esthetics Katherine Tai, Margareta Morrissette, Jin Hua Li, Michael Dib, Ilexa Schechter, Andy Hickner, Anthony P. Sclafani 10.1016/j.fsc.2026.04.001 Facial Plastic Surgery Clinics (2026) 2026-06-05 Facial Plastic Surgery Clinics 2026-06-05 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00032-5/fulltext?rss=yes Autologous fat transfer has progressed from a volumetric filler to a regenerative cornerstone in modern facial plastic and reconstructive surgery. This article reviews the biological basis, technical refinements, and current processing systems that underpin facial fat grafting. Adipose tissue functions as both a biocompatible filler and a regenerative organ enriched with adipose-derived stem cells and stromal vascular fraction, driving angiogenesis, collagen remodeling, and skin rejuvenation. Commercial systems Puregraft, REVOLVE, Lipocube, and Tulip Nanofat are compared in terms of purification mechanisms, benefits, and clinical use. These closed sterile systems enhance safety, standardization, and predictability, bridging aesthetic artistry with regenerative science. Liporeinjection of Fat, Nanofat, and Stromal Vascular Fraction Chim Yang, James Newman 10.1016/j.fsc.2026.04.002 Facial Plastic Surgery Clinics (2026) 2026-06-04 Facial Plastic Surgery Clinics 2026-06-04 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00046-5/fulltext?rss=yes Regenerative medicine has become an increasingly important focus in aesthetic and reconstructive surgery, reflecting a shift from purely structural interventions toward approaches that aim to restore tissue function and enhance intrinsic repair. In facial plastic surgery, this evolution has been driven by advances in stem cell biology, molecular signaling, and biomaterials, alongside growing patient demand for treatments that improve tissue quality and recovery. Healing from Within: Biologics in Facial Plastic Surgery Allison Pontius, Gregory Keller 10.1016/j.fsc.2026.05.011 Facial Plastic Surgery Clinics (2026) 2026-05-28 Facial Plastic Surgery Clinics 2026-05-28 Preface https://www.facialplastic.theclinics.com/article/S1064-7406(26)00045-3/fulltext?rss=yes There are, in effect, two things, to know and to believe one knows; to know is science; to believe one knows is ignorance.—Hippocrates (c. 460– c. 370 bc) The Natural Healing Force Within Each of Us Anthony P. Sclafani 10.1016/j.fsc.2026.05.010 Facial Plastic Surgery Clinics (2026) 2026-05-27 Facial Plastic Surgery Clinics 2026-05-27 Foreword https://www.facialplastic.theclinics.com/article/S1064-7406(26)00008-8/fulltext?rss=yes A persistently crooked nose refers to a condition in which the deviation of the nasal pyramid from the facial midline remains or reappears after the rhinoplasty surgery. Asymmetries in any compartment of the nose are among the main concerns of patients seeking revision rhinoplasty. Therefore, mastering surgical techniques to address these issues is essential to achieve success in revision cases. In this article, we discuss various surgical techniques, present case examples, and provide supplementary revision rhinoplasty videos performed by the senior author to enhance understanding. Techniques for the Persistently Crooked Nose Süreyya Şeneldir, Esat Nursoy 10.1016/j.fsc.2026.01.008 Facial Plastic Surgery Clinics 34, 2 (2026) 2026-03-19 Facial Plastic Surgery Clinics 2026-03-19 34 2 S1064-7406(26)X2001-6 277 287 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00015-5/fulltext?rss=yes Hyperbaric oxygen therapy (HBOT) has proven to be very helpful to rhinoplasty healing, particularly in complex rhinoplasty defects involving compromised vascularity, the use of flaps or composite grafts, and in cases with prior infection. Outcomes can be maximized when HBOT is combined with nanofat and the Silastic healing chamber. Safety and comfort are critical in the application of HBOT in rhinoplasty The Use of Hyperbaric Oxygen Therapy in Secondary Rhinoplasty Dean M. Toriumi 10.1016/j.fsc.2026.01.015 Facial Plastic Surgery Clinics 34, 2 (2026) 2026-03-18 Facial Plastic Surgery Clinics 2026-03-18 34 2 S1064-7406(26)X2001-6 177 206 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00017-9/fulltext?rss=yes Rhinoplasty is hard. Secondary rhinoplasty is harder. It is also one of the most rewarding operations I’ve had the privilege of performing. Patients seeking a secondary operation are often scared and nervous and may even be traumatized. They may also have lost their trust in health care—both in the ability of a surgeon to deliver the promised results and in their ability to choose someone to help them. A successful operation will not only heal the nose but also restore this trust. However, a favorable outcome depends on a patient who is emotionally and physically ready for surgery and a surgeon who has the tools to deal with the unpredictability of depleted cartilage, distorted anatomy, and a damaged soft tissue envelope. One Step Back, Two Steps Forward Grant S. Hamilton 10.1016/j.fsc.2026.02.002 Facial Plastic Surgery Clinics 34, 2 (2026) 2026-03-02 Facial Plastic Surgery Clinics 2026-03-02 34 2 S1064-7406(26)X2001-6 Preface xiii xiv https://www.facialplastic.theclinics.com/article/S1064-7406(26)00003-9/fulltext?rss=yes Nasal implants are an integral part of both functional and cosmetic rhinoplasty. Alloplastic materials remain as a popular choice of nasal implant, especially in areas of the world where augmentation rhinoplasty is frequently performed. Many rhinoplasty surgeons and patients favor the use of alloplastic implants due to its advantages. Among the possible complications, extrusion and infection remain as the 2 of the most feared and dreaded complications in the use of alloplastic implants. In this review, we aim to highlight some of the unique challenges the revision rhinoplasty surgeon might face and our recommendations to their management. Revising the Extruding or Infected Alloplastic Implant Chak Yuen Fung, Yong Ju Jang 10.1016/j.fsc.2026.01.003 Facial Plastic Surgery Clinics 34, 2 (2026) 2026-02-25 Facial Plastic Surgery Clinics 2026-02-25 34 2 S1064-7406(26)X2001-6 217 228 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00002-7/fulltext?rss=yes In a standard septoplasty, most of the quadrangular cartilage is resected while preserving an L-strut to maintain structure of the nose. Deviation may recur due to contractile forces causing flexure or torsion of the L-strut, which may be reduced by modifying the shape of the L-strut chondrotomy. Alternatively, deviations may have been insufficiently addressed by the initial septoplasty. Grafting techniques are often used to address deviations of the L-strut, and repositioning of the posterior septal angle may be required when displaced off the anterior nasal spine. With certain severe sepal deformities, extracorporeal septoplasty may be a more effective option. Strategies for the Previously Operated Septum Derek H. Liu, Grant S. Hamilton, Brian J.F. Wong 10.1016/j.fsc.2026.01.002 Facial Plastic Surgery Clinics 34, 2 (2026) 2026-02-25 Facial Plastic Surgery Clinics 2026-02-25 34 2 S1064-7406(26)X2001-6 207 216 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00018-0/fulltext?rss=yes Difficulties strengthen the mind, as labor strengthens the body.— Seneca the Younger (4 bc–65 ad), Letters from a Stoic That Which Does Not Kill Us… Anthony P. Sclafani 10.1016/j.fsc.2026.02.003 Facial Plastic Surgery Clinics 34, 2 (2026) 2026-02-24 Facial Plastic Surgery Clinics 2026-02-24 34 2 S1064-7406(26)X2001-6 Foreword xi https://www.facialplastic.theclinics.com/article/S1064-7406(26)00012-X/fulltext?rss=yes Over the previous decade, regenerative medicine has been emerging as a new paradigm in facial plastic surgery in the treatment of skin quality and longevity. Its emergence has begun reshaping how we can approach complex nasal reconstruction and revision rhinoplasty, in particular, where vascular compromise, scarring, and contracture often limit traditional techniques and diminish results. Biologic adjuncts such as stem cells, nanofat, platelet-rich plasma, and exosomes are offering a way to complement mechanical derangement with cellular support. Regenerative Biologics in Revision Rhinoplasty Dustin J. Jones, Dean M. Toriumi 10.1016/j.fsc.2026.01.012 Facial Plastic Surgery Clinics 34, 2 (2026) 2026-02-24 Facial Plastic Surgery Clinics 2026-02-24 34 2 S1064-7406(26)X2001-6 323 328 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00010-6/fulltext?rss=yes Dorsal preservation rhinoplasty is becoming more widely used due to the ability to preserve the dorsal bony-upper lateral cartilage junction, the dorsal septum to the ethmoid, and nasal ligaments. While this technique offers some advantages compared to other rhinoplasty techniques, it is important to assess patients’ candidacy for dorsal preservation techniques preoperatively to avoid surgical complications. This article discusses key considerations when performing dorsal preservation rhinoplasty including identifying blocking points. The authors also discuss their revision techniques for addressing complications in dorsal preservation rhinoplasty. Revising the Dorsal Preservation Rhinoplasty Patient Kieran Steffen Boochoon, Jose Enrique Barrera 10.1016/j.fsc.2026.01.010 Facial Plastic Surgery Clinics 34, 2 (2026) 2026-02-24 Facial Plastic Surgery Clinics 2026-02-24 34 2 S1064-7406(26)X2001-6 303 311 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00007-6/fulltext?rss=yes This review examines camouflage strategies in secondary rhinoplasty, including cosmetic makeup, injectable fillers, autologous fat grafting, fascia, cartilage, bone paste, and allogenic materials. Autologous cartilage—particularly diced or paste preparations—remains the most reliable option for long-term dorsal camouflage, whereas fascia provides smooth coverage for thin-skinned patients. Fat grafting offers both volume and regenerative benefits, although resorption is variable. AlloDerm, pericardium, and implants can be alternatives when autologous tissue is limited but carry higher complication risks. Current evidence is constrained by small cohorts and subjective assessments, underscoring the need for individualized selection and ongoing refinement of camouflage techniques. Camouflage Techniques in Secondary Rhinoplasty Abel-Jan Tasman 10.1016/j.fsc.2026.01.007 Facial Plastic Surgery Clinics 34, 2 (2026) 2026-02-24 Facial Plastic Surgery Clinics 2026-02-24 34 2 S1064-7406(26)X2001-6 265 275 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00013-1/fulltext?rss=yes Evidence-based strategies to optimize recovery following secondary (revision) rhinoplasty are detailed herein. We emphasize a holistic, proactive approach that encompasses the entire surgical process, from patient selection to preoperative optimization of sleep and nutrition, to postoperative adjuncts to support healing. The review highlights intraoperative techniques to improve outcomes, as well as postoperative protocols to manage pain, edema, ecchymosis, and scarring using both pharmacologic and nonpharmacologic methods. Successful revision rhinoplasty hinges as much on meticulous planning and patient management as surgical technique. Optimizing Recovery in the Secondary Rhinoplasty Patient Morgan Terry, Natalie A. Krane 10.1016/j.fsc.2026.01.013 Facial Plastic Surgery Clinics 34, 2 (2026) 2026-02-19 Facial Plastic Surgery Clinics 2026-02-19 34 2 S1064-7406(26)X2001-6 329 338 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00011-8/fulltext?rss=yes Infection after rhinoplasty is uncommon but potentially devastating, threatening both functional and aesthetic outcomes. Reported rates range from 0.2% to 2%, with higher risk in revision cases and when grafts or implants are used. This article reviews the microbiology, risk factors, and clinical presentation of post-rhinoplasty infections, and outlines evidence-based strategies for prevention and treatment. Emphasis is placed on optimizing patient selection, perioperative prophylaxis, meticulous surgical technique, and careful graft choice. Practical algorithms for diagnosis and management are presented, aiming to reduce complication rates and guide clinicians in delivering safe, predictable surgical outcomes. Prevention and Treatment of Infection in Rhinoplasty Santdeep Paun, Hao Meng Yip 10.1016/j.fsc.2026.01.011 Facial Plastic Surgery Clinics 34, 2 (2026) 2026-02-19 Facial Plastic Surgery Clinics 2026-02-19 34 2 S1064-7406(26)X2001-6 313 321 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00006-4/fulltext?rss=yes Thick skin is a challenge in secondary rhinoplasty, frequently compromising both aesthetic outcomes and the predictability of surgical interventions. This article presents an integrated approach to the management of thick skin in patients undergoing secondary rhinoplasty. The described protocol encompasses preoperative, intraoperative, and postoperative strategies designed to reduce and control swelling, edema, and inflammation as much as possible. It incorporates topical and systemic medical therapies, dietary modifications, structured skin stretching exercises, and surgical techniques including superficial musculoaponeurotic system debulking, skeletal augmentation, structural grafting, and control of dead space formation. Management and Limitations of Thick Skin in the Secondary Patient Roxana Cobo 10.1016/j.fsc.2026.01.006 Facial Plastic Surgery Clinics 34, 2 (2026) 2026-02-19 Facial Plastic Surgery Clinics 2026-02-19 34 2 S1064-7406(26)X2001-6 245 256 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00001-5/fulltext?rss=yes Patients seek facial plastic surgery to feel better, not only look better. As surgery is an inherently traumatic event, regardless of the result, patients seeking secondary facial plastic surgery procedures should be evaluated for possible traumatic response to prior surgery in initial consultation. Herein, we cover the history of trauma and trauma-informed counseling along with common approaches employed by counselors certified in this therapeutic approach. If signs of traumatic response are identified, trauma-informed counseling offers a valuable intervention to improve care. Basics of Trauma-Informed Care for the Facial Plastic Surgeon Barbara Mullen, Miguel G. Ferreira, Grant S. Hamilton 10.1016/j.fsc.2026.01.001 Facial Plastic Surgery Clinics 34, 2 (2026) 2026-02-18 Facial Plastic Surgery Clinics 2026-02-18 34 2 S1064-7406(26)X2001-6 169 176 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00014-3/fulltext?rss=yes Achieving optimal control of the nasal tip and middle vault remains one of the greatest challenges in rhinoplasty, particularly when addressing the complex dynamics of the lateral crura. The DELTA GRAFT is introduced as a novel structural and functional graft that offers a unified solution to multiple aesthetic and functional concerns. This technique allows precise modulation of lateral crus shape and eversion, adjusts the resting angle, redefines the crural–septal relationship, and stabilizes both internal and external nasal valves. Additionally, it facilitates controlled tip rotation and support using a single, strategically positioned graft. The Delta Graft Miguel Gonçalves Ferreira, Mariline Santos, Grant S. Hamilton 10.1016/j.fsc.2026.01.014 Facial Plastic Surgery Clinics 34, 2 (2026) 2026-02-16 Facial Plastic Surgery Clinics 2026-02-16 34 2 S1064-7406(26)X2001-6 339 346 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00009-X/fulltext?rss=yes Revision rhinoplasty is one of the most challenging procedures in facial plastic surgery. With the appropriate approach and techniques, it may be handled with both caution and confidence. This article details the senior author’s approach to revision rhinoplasty and specifically reconstruction of the nasal valves, with attention to surgical technique and decision-making, and has shown excellent long-term esthetic and functional results. This surgical framework is broadly applicable and adaptable to meet the unique needs of revision rhinoplasty candidates. Revision Rhinoplasty Elizabeth S. Longino, Sam P. Most 10.1016/j.fsc.2026.01.009 Facial Plastic Surgery Clinics 34, 2 (2026) 2026-02-16 Facial Plastic Surgery Clinics 2026-02-16 34 2 S1064-7406(26)X2001-6 289 302 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00004-0/fulltext?rss=yes Revision rhinoplasty remains one of the most demanding procedures in facial plastic surgery, challenging not only because of the altered anatomy, deficiencies of structural support, and complex 3-dimensional morphology of the nose, but also because of the varying degrees of scarring. Although the open approach dominates contemporary revision rhinoplasty practice, the endonasal technique remains a valuable option in appropriately selected patients. By preserving the skin–soft tissue envelope and the intrinsic ligamentous support of the nose, endonasal revision offers advantages including reduced edema, avoidance of external scars, and maintenance of a more natural nasal appearance and feel. Endonasal Secondary Rhinoplasty Techniques Andre Shomorony, Oren Friedman 10.1016/j.fsc.2026.01.004 Facial Plastic Surgery Clinics 34, 2 (2026) 2026-02-16 Facial Plastic Surgery Clinics 2026-02-16 34 2 S1064-7406(26)X2001-6 229 236 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00005-2/fulltext?rss=yes This article reviews evidence-based strategies for preserving and salvaging the nasal skin–soft tissue envelope (SSTE) in revision rhinoplasty, where prior surgical intervention often leaves diminished vascularity, scarring, and reduced tissue quality. Because SSTE integrity is pivotal to long-term functional and aesthetic success, the discussion addresses relevant anatomy, pathophysiologic mechanisms, and risk factors for compromise and presents an algorithmic approach to prevention, early recognition, and timely intervention. Salvaging the Compromised Soft-Tissue Envelope in Revision Rhinoplasty Neal Deot, Paul S. Nassif 10.1016/j.fsc.2026.01.005 Facial Plastic Surgery Clinics 34, 2 (2026) 2026-02-10 Facial Plastic Surgery Clinics 2026-02-10 34 2 S1064-7406(26)X2001-6 237 244 https://www.facialplastic.theclinics.com/article/S1064-7406(26)00025-8/fulltext?rss=yes Healing from Within: Biologics in Facial Plastic Surgery Forthcoming Issues 10.1016/S1064-7406(26)00025-8 Facial Plastic Surgery Clinics 34, 2 (2026) 2026-05 Facial Plastic Surgery Clinics 2026-05 34 2 S1064-7406(26)X2001-6 ix https://www.facialplastic.theclinics.com/article/S1064-7406(26)00024-6/fulltext?rss=yes Anthony P. Sclafani Contents 10.1016/S1064-7406(26)00024-6 Facial Plastic Surgery Clinics 34, 2 (2026) 2026-05 Facial Plastic Surgery Clinics 2026-05 34 2 S1064-7406(26)X2001-6 v viii https://www.facialplastic.theclinics.com/article/S1064-7406(26)00023-4/fulltext?rss=yes ANTHONY P. SCLAFANI, MD, MBA, FACS Contributors 10.1016/S1064-7406(26)00023-4 Facial Plastic Surgery Clinics 34, 2 (2026) 2026-05 Facial Plastic Surgery Clinics 2026-05 34 2 S1064-7406(26)X2001-6 iii iv https://www.facialplastic.theclinics.com/article/S1064-7406(26)00022-2/fulltext?rss=yes ELSEVIER Copyright 10.1016/S1064-7406(26)00022-2 Facial Plastic Surgery Clinics 34, 2 (2026) 2026-05 Facial Plastic Surgery Clinics 2026-05 34 2 S1064-7406(26)X2001-6 ii https://www.facialplastic.theclinics.com/article/S1064-7406(26)00021-0/fulltext?rss=yes FACIAL PLASTIC SURGERY CLINICS OF NORTH AMERICA Complications and Revision in Rhinoplasty Grant S. Hamilton III 10.1016/S1064-7406(26)00021-0 Facial Plastic Surgery Clinics 34, 2 (2026) 2026-05 Facial Plastic Surgery Clinics 2026-05 34 2 S1064-7406(26)X2001-6 i https://www.facialplastic.theclinics.com/article/S1064-7406(26)00016-7/fulltext?rss=yes Most rhinoplasty patients have insufficient reconstructive cartilage, which is often required for structural considerations like tip support, reconstructing internal or external nasal valves, or for dorsal augmentation or camouflage. When there is insufficient septal cartilage, the surgeon must turn to other cartilaginous sources including ear cartilage, autologous rib cartilage, or cadaveric rib cartilage. While adding rib cartilage harvest, surgeons often hesitate with autologous rib cartilage as the case may be prolonged or possible increased morbidity due to the risk of a pneumothorax. However, following proper technique, rib cartilage can be easily and safely harvested and is reliable in secondary rhinoplasty. Safe and Simple Costal Cartilage Harvest Grace Lee Peng, Grant S. Hamilton 10.1016/j.fsc.2026.02.001 Facial Plastic Surgery Clinics 34, 2 (2026) 2026-05 Facial Plastic Surgery Clinics 2026-05 34 2 S1064-7406(26)X2001-6 257 263