Predictors of the effectiveness of multimodal noninvasive facial rejuvenation: a conceptual model incorporating skin condition, soft-tissue characteristics, edema, and muscle tone

Current noninvasive facial rejuvenation methods can target different tissue layers; however, treatment outcomes vary considerably even when comparable protocols are used. Accordingly, predicting treatment response based on patients' baseline characteristics represents a promising direction. The aim of this study is to systematize potential predictors of the effectiveness of multimodal noninvasive facial rejuvenation and to develop a conceptual multifactorial model for predicting treatment response. The study materials comprised clinical studies and review articles addressing age-related facial changes, radiofrequency technologies, microfocused ultrasound, neuromuscular stimulation, midfacial edema, and methods for assessing aesthetic outcomes. Comparative analysis, systematization, and conceptual modeling were employed. Four groups of potential predictors were identified: skin condition, soft-tissue characteristics, predisposition to edema, and the status of the muscular component. Treatment response is proposed to be evaluated across several domains: changes in skin quality, the degree of lifting and changes in soft-tissue shape, stability of the outcome in patients predisposed to edema, and changes in features associated with muscle tone. A matrix linking baseline characteristics to the anticipated response was developed, five typical response profiles were defined, and a framework for subsequent clinical validation of the model was proposed. The findings support a shift toward outcome prediction that integrates the patient's baseline phenotype with the characteristics of the intervention applied.