Background Extracorporeal shockwave therapy (ESWT) represents a promising, non-invasive management strategy supporting the treatment of a variety of conditions related to plastic surgery. Objectives This literature review aims to give a systematic overview of current applications, its mechanism of action, and its potential to provide tangible therapies in plastic surgery. Methods The databases PubMed (National Institute of Health, Bethesda, MD), Embase (via Ovid [Elsevier, Amsterdam, the Netherlands]) and the Cochrane Library (Cochrane, London, United Kingdom) were searched for articles published up to June 1, 2021. Clinical studies of any design, including ESWT in the context of plastic surgery, were included. Two reviewers extracted data and 46 articles were analyzed after application of the inclusion and exclusion criteria. Results Forty-six included studies (n = 1496) were categorized into the following broad themes; Cellulite/Body Contouring/Skin rejuvenation, Burns/Scar treatment, Diabetic Foot Ulcers/Chronic Wound and Future perspectives of ESWT. Overall, applications of ESWT were heterogenous and the majority of studies reported effectiveness of ESWT as alternative treatment technique. Flawed methodology and differences in technical standards limit outcome and conclusion of this review. Conclusions There is yet insufficient evidence to support the effectiveness of any specific intervention included in this review, however, all included studies report improvements in key outcomes. Where reported, ESWT displays a good safety profile with no serious adverse events. Further research is needed to provide more evidence in order to delineate the indications of ESWT in plastic surgery.

Background The Hemostatic Net has been promoted as a safe and effective method to prevent hematoma formation following facelift procedures. To date there is little published evidence to validate the replicability and effectiveness of the technique. Objectives This study presents 2 cohorts of facelift patients from a single surgeon‘s practice to assess the impact of the Hemostatic Net on hematoma formation. Methods The records of 304 patients were reviewed in whom the Hemostatic Net was placed following a facelift between July 2017 and October 2022. Data was collected and assessed for complications and compared with a control group of 359 patients who underwent a facelift procedure by the same surgeon between 1999 and 2004. Results A total of 663 patients were included. In this retrospective cohort study, analysis of available data showed a significantly reduced hematoma rate of 0.6% in the intervention group compared to 3.9% in the control group (p = 0.006722). Conclusions The use of the Hemostatic Net is a safe, reproducible and effective technique in reducing the risk of hematoma in facelift surgery.

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