Carboxytherapy in Aesthetic Medicine and Aesthetic Surgery: A Narrative Review

BACKGROUND: Carboxytherapy refers to the use of CO2 gas for several therapeutic purposes. CO2 has numerous physiological effects, most notably promoting the Bohr effect causing a decrease in hemoglobin affinity for oxygen and thereby increasing oxygen delivery to the treated area. Carboxytherapy historically was applied in a percutaneous manner, however recent advancements have made topical forms available. Over the last several decades, practitioners have utilized carboxytherapy for aesthetic purposes. The purpose of this article is to review the applications of carboxytherapy in aesthetic surgery and medicine. METHODS: A comprehensive review of the literature was performed using a number of search terms related to carboxytherapy. Articles were reviewed and selected by two independent reviewers. Due to the heterogeneity of the articles, a narrative review was performed. RESULTS: Ultimately, 32 articles were selected for review. The articles focused on periorbital rejuvenation, facial rejuvenation, lipolysis, and transcutaneous applications. The available research suggests that transcutaneous carboxytherapy can address periorbital hyperpigmentation. Additionally, it can potentially reduce fine lines and wrinkles in the face and lead to mild lipolysis in the treated area. Finally, topical carboxytherapy gel shows early promise for improving local healing and tissue oxygenation. CONCLUSIONS: Carboxytherapy shows potential as a therapy in aesthetic surgery and medicine, particularly for periorbital hyperpigmentation, facial wrinkles, and lipolysis. Additionally, the topical form is of potential great interest to plastic surgeons as an adjunct for tissue healing and oxygenation after surgical and non-surgical treatments. Further research is needed to support these findings and provide comprehensive clinical guidelines.